Ethics rounds in the ambulance service: a qualitative evaluation

Area of Science:

• Medical Ethics
• Emergency Medical Services
• Healthcare Professional Development

Background:

• Ambulance clinicians face ethical challenges caring for patients with impaired decision-making capacity.
• Ethical competence is crucial for ambulance clinicians to navigate complex ethical dilemmas.
• Ethics rounds, a model for enhancing ethical competence, have not been previously applied in ambulance services.

Purpose of the Study:

• To describe ambulance clinicians' experiences participating in ethics rounds.
• To evaluate the impact of ethics rounds on ethical competence in the pre-hospital setting.

Main Methods:

• Qualitative descriptive study evaluating an intervention.
• Data collected through 16 interviews with ambulance clinicians.
• Content analysis used for data interpretation.

Main Results:

• Two main themes emerged: "Reflecting freely within a given framework" and "Being surprised by new insights."
• Categories included gentle facilitation, comprehensible structure, new awareness of ethical problems, and shared learning through dialogue.

Conclusions:

• Structured ethics rounds foster continuous development of ethical competence, potentially improving ambulance service quality of care.
• Facilitated group reflection and structured guidance support personal and professional growth for clinicians.
• Well-educated facilitators are essential for the success of ethics rounds as a pedagogical model in ambulance services.