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

The law plays an important role in governing end-of-life decision-making in paramedic practice. A scoping review was undertaken to identify and examine the extent, range and nature of literature on the legal issues relevant to end-of-life clinical practice for Australian paramedics. Documents (scholarly works and/or policies) were identified by searching electronic databases, Google Scholar, professional organisation and State/Territory health department websites, scanning reference lists and drawing on authors' existing knowledge. Sixteen of the 22 documents identified were policies, including clinical practice guidelines or similar documents from the various State/Territory Ambulance services, and policies from State/Territory Health Departments or resuscitation organisations. Common legal issues were consent to treatment, decision-making capacity, withholding and withdrawing life-sustaining treatment, advance care planning, substitute decision-making, emergency treatment and children and end-of-life decision-making. Gaps included documents focusing on paediatric clinical practice and broad practice guidelines on end-of-life care for paramedics working in some jurisdictions.