Today’s question raises an issue of duty of care.  The question

is in regard to who has the higher Duty of Care in an out of hospital setting. Does a Medical Officer have a ‘greater’ duty of care to a sick or injured person out of hospital if paramedics are in attendance?? Can a Paramedic recommend strongly to a medical officer that the treatment needs to divert from the path that the MO is currently following?

The quick and strict answer is that no-one owes a ‘higher’ duty or standard of care.    Where there is a duty of care, the standard of care expected is the same for everyone.  The duty is a duty to act reasonably in the circumstances. But that is not helpful and I don’t think what I’m being asked. The relevant circumstances are that one person is ‘medical officer’ (read registered medical practitioner) and the other a paramedic so does someone have more responsibility or authority.

Like all good answers it depends on the circumstances.  If the patient is under the care of the medical practitioner and the medical practitioner has requested an ambulance to transport the patient to a hospital or nursing home then he or she will have established a treatment regime and would be asking the paramedics to continue that treatment as they transport the patient to their destination.

Alternatively if the person is previously unknown to the doctor and becomes suddenly ill or is injured the doctor is not somehow in charge of the patient and able to direct the paramedics.  The paramedics are not the doctor’s servant or agent, they are there to provide paramedic care and you would expect the doctor to get out of their way as they are the experienced out of hospital practitioners and they are the ones who have to transport the patient to hospital.

For a more detailed discussion, see Step aside – I’m a doctor (October 17, 2014).