Legal Issues in End-of-Life Care for Paramedics: A Scoping Review

Area of Science:

• Legal Studies
• Medical Ethics
• Paramedic Practice

Background:

• The law significantly influences end-of-life decision-making within paramedic practice.
• Understanding these legal parameters is crucial for Australian paramedics providing care.

Purpose of the Study:

• To conduct a scoping review of literature on legal issues in end-of-life clinical practice for Australian paramedics.
• To identify the extent, range, and nature of existing legal documentation.

Main Methods:

• A comprehensive search strategy was employed, including electronic databases, Google Scholar, and professional/governmental websites.
• Reference lists were scanned, and authors' existing knowledge was utilized to identify relevant documents.
• The review included scholarly works and policies, with a focus on clinical practice guidelines.

Main Results:

• Sixteen of 22 identified documents were policies, primarily clinical practice guidelines from Ambulance services and Health Departments.
• Common legal issues identified include consent, decision-making capacity, life-sustaining treatment, advance care planning, and pediatric end-of-life decisions.
• Gaps were noted in literature concerning pediatric clinical practice and comprehensive end-of-life care guidelines for paramedics in certain jurisdictions.

Conclusions:

• Existing policies address several key legal aspects of paramedic end-of-life care in Australia.
• There is a need for expanded guidelines, particularly for pediatric cases and broader end-of-life care across all jurisdictions.