Rescue at Extreme Altitude: Managing the Ethical Considerations in the Language of Risk Management. An International...

Ellerton, John, Alison Sheets, Kyle McLaughlin, and Peter Paal. Rescue at Extreme Altitude: Managing the Ethical Considerations in the Language of Risk Management. An International Commission for Alpine Rescue Position Paper. High Alt Med Biol. 27:117-122, 2026.Rescue from altitude has additional risks that require specialist knowledge, skills, and ability. Currently, rescue at extreme altitude (>5,500 m) is provided largely by ad-hoc teams responding to a need. The ethics of performing such rescues is controversial, and media coverage rarely considers the complexity of the environment. Organized mountain rescue teams have established processes to manage risk and their conduct to provide a professional service that changes the language of ethical decision-making into a practical, nuanced risk and crew resource management format. The International Commission for Alpine Rescue, along with the International Society of Mountain Medicine, has produced scientific papers on rescue at very high altitude and a position paper on the ethics of extreme altitude rescue. The aim is to improve the safety and outcomes of all rescues at altitude. The position paper, presented here, is targeted principally at those involved in extreme altitude rescue. Organized mountain rescue developed from ad-hoc rescue in response to a need; the same is likely to occur for extreme altitude rescue. Altitude is only one of the risk factors, and the knowledge of modern mountain rescue processes could aid in the advancement of extreme altitude rescue.