This question came as a comment on the post State of Queensland liable for paramedic negligence (December 22, 2016) but I thought it warranted its own post rather than a reply as a comment.

I advise a church group who run public assemblies and as part of the function have a ‘first aid’ area where people can go and get items that are in commercial first aid kits. They also sometimes have members who are paramedics on hand in an off-duty volunteer capacity. What liability would there be for the church or the volunteer paramedic if the volunteer paramedic administered morphine or adrenalin in an emergency situation and the situation go worse? The question was asked for application in QLD. Would your answer be different if it were NSW for example? I was considering suggesting to the church that it would be up to the volunteer paramedic to choose if he wanted to have his own supply of morphine on hand. In my mind I think it would be best if he did not and simply provided whatever help he could until on-call ambulance/paramedics arrived on the scene.

The reason the State of Queensland was liable for paramedic negligence is because the paramedic was employed by Queensland Ambulance providing care in the course of his duties as an employed paramedic.  Vicarious liability applies to ensure employers are liable for the negligence of their employees and agents.

If paramedics are attending church service as volunteers and part of their volunteering duties is to provide first aid, then they are not liable for any damages arising from their volunteering (Civil Liability Act 2003 (Qld) s 39).  The Act, unlike the NSW Act, does not say whether or not the organisation for which the person is volunteering also benefits from that defence (see  the church for which the volunteer will be liable for any negligence (Vicarious liability for NSW Ambulance paramedics (August 19, 2017)).

The fact that question is asked in the negative – ‘what is our liability if we do x and it goes wrong?’ is reflected in the questions I get asked regularly about restricting scope of practice – see Scope of practice revisited (August 14, 2017)).  The better question to ask is what is our liability if we don’t do x – in context of this question “What liability would there be for the church or the volunteer paramedic if the volunteer paramedic did not administer morphine or adrenalin in an emergency situation and the situation go worse?”

The answer, in this context has to be there would be no liability.  Morphine and adrenaline are scheduled drugs under the Health (Drugs and Poisons) Regulation 1996 (Qld).  That regulation applies the Poisons Standard that is made under the Therapeutic Goods Act 1989 (Cth) into Queensland law.

For the purposes of the Queensland regulation, a schedule 8 drug is referred to as a ‘controlled drug’; a schedule 4 drug is a ‘restricted drug’.   Morphine in its various forms appears in Schedules 2, 4 and 8.   Adrenaline appears in Schedules 3 and 4 (and for a discussion on adrenaline delivered via EpiPen see Using someone else’s EpiPen (June 9, 2016)).  Without going into all the details of the Schedules, you can infer that scheduled 2 and 3 drugs should be supplied by a pharmacist and Schedule 4 and Schedule 8 drugs must be supplied on prescription or by an authorised person.

It is an offence to possess or supply controlled (r 51) or restricted drugs (r 146) without the appropriate lawful authority and without ensuring that the drugs are stored and recorded in accordance with the regulations.  Queensland ambulance officers are given permission ‘To the extent necessary for performing ambulance duties for the Queensland Ambulance Service…’ to ‘obtain, possess or administer’ listed controlled (r 66) and restricted (r 174) drugs.

What follows is that if there was controlled or restricted drugs in the church first aid kit that people could just help themselves to, the church would be committing a criminal offence. If an off duty paramedic was carrying his or her ‘own supply of morphine on hand’ they too would be committing an offence, as their authority only extends to carry the drugs for the purpose of ‘performing ambulance duties for the Queensland Ambulance Service’ and if they are attending church, off duty, that is not what they are doing.

So what would be the liability for not administering the drugs that were warranted by the patient’s condition? In this context the answer is clearly ‘there would be no liability’.  What the reasonable person does in response to an emergency depends on all the circumstances. The circumstances under consideration here are where the person does not have access to those drugs because it is illegal to have them in one’s possession without appropriate authority.  A paramedic can’t be judged negligent for not doing what he or she can’t do.  And you can’t administer drugs you don’t have and aren’t legally allowed to have.   Of course if someone else in the crowd has an EpiPen and volunteers it, it may be problematic if the church leader said to the paramedic – ‘don’t use that, it’s not our drug and we’re afraid we’ll get sued if you use it and things get worse, which might happen; we’d rather you didn’t use it and watch things get worse, which will happen’.


The question “What liability would there be for the church or the volunteer paramedic if the volunteer paramedic administered morphine or adrenalin in an emergency situation and the situation go worse?” is the wrong question.

The starting question should have been ‘can we have morphine and/or adrenaline in our first aid kit?’ and the answer to that is ‘no’.  That pretty much ends the debate.   Neither the church nor an off duty paramedic can possesses restricted or controlled drugs; and there can be no liability for not doing that which the law prohibits.

If for some reason the drugs are available, eg a person has an EpiPen which they are willing to give to a person suffering from an anaphylactic reaction, the church should not be concerned with questions of liability if it is used; but with questions of liability if they attempt to stop it being used.  The paramedic, or a first aider, or anyone who knows what they are doing, should always do all that they can to save a life.