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Current controversy
Paramedic delivery of bad news: a novel dilemma during the COVID-19 crisis
  1. Iain Campbell1,2
  1. 1 Centre for Ethics in Medicine, University of Bristol Faculty of Health Sciences, Bristol, UK
  2. 2 Paramedic, London Ambulance Service, London, UK
  1. Correspondence to Iain Campbell, Centre for Ethics in Medicine, University of Bristol Faculty of Health Sciences, Bristol BS8 1TL, UK; iaincampbell8{at}gmail.com

Abstract

As a result of the COVID-19 global pandemic, paramedics in the UK face unprecedented challenges in the care of acutely unwell patients and their family members. This article will describe and discuss a new ethical dilemma faced by clinicians in the out-of-hospital environment during this time, namely the delivery of bad news to family members who are required to remain at home and self-isolate while the critically unwell patient is transported to hospital. I will discuss some failings of current practice and reflect on some of the ethical and practical challenges confronting paramedics in these circumstances. I conclude by making three recommendations: first, that dedicated pastoral outreach teams ought to be set up during pandemics to assist family members of patients transported to hospital; second, I offer a framework for how bad news can be delivered during a lockdown in a less damaging way; and finally, that a new model of bad news delivery more suited for unplanned, time-pressured care should be developed.

  • clinical ethics
  • emergency medicine

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/medethics-2020-106710

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    Footnotes

    • Twitter @Iain_A_C

    • Contributors This work is the author's own and does not represent the views of the institution the author works or studies in.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement There are no data in this work.