Today’s correspondent asks:

… if two paramedics respond to a case, and during their care one of them is seriously injured (let’s say they are responding to a patient in cardiac arrest following an unknown industrial accident, and during care one paramedic is accidentally electrocuted and becomes unconscious), is there any legal guidance on the responsibilities of the second paramedic in regards to who they chose to treat?

For example, I would assume that the remaining paramedic would now care for their partner (the paramedic), even if it meant that the patient was not cared for at all until back-up arrives.

Is there any legal guidance on this? I assume that our duty of care to the patient is superseded by scene safety and therefore the patient is always at a lower priority than the crew.

It is certainly NOT the case that ‘our duty of care to the patient is superseded by scene safety and therefore the patient is always at a lower priority than the crew’.  If scene safety were the issue and paramedic 2 was electrocuted, then presumably paramedic 1 would withdraw until the scene could be made safe.

The duty to the two patients has to be the duty any paramedic owes in a situation where the number of patients exceeds the number of paramedics on scene. The issue would be determined by the principles of triage and assessing clinical need.  Patient and the safety of the treating paramedic will come into it.  If there is a patient that ideally should be treated with higher priority but he or she cannot be safely accessed, then a paramedic would treat the other patient first.   And if it is too dangerous for the crew to enter then that is fair enough.

In this scenario however, assuming Paramedic 1 is no longer at risk, the decision to treat should be based on principles of need and triage, not that Paramedic 1 owes some predominant duty to paramedic 2 over and above any duty owed to patient 1.  A critical ethical principle in medical care is ‘justice’ that is giving aid to those that need it on the basis of their need and not for judgements to do with status, personal loyalty etc.  It would be understandable if paramedic 1 sought to treat his or her friend and colleague first, that may be a natural inclination, but it is certainly not going to be a legal duty.  And if paramedic 2 is clearly not as badly injured as the original patient, such that triage would say treat the original patient first, it may be a breach of duty to that patient to withdraw treatment in favour of a colleague.

For a related discussion see – Gabriella Marchant ‘Paternal instinct’ led Hindley Street doctor to treat his daughter first, inquest hears’ ABC News (Online) 14 Feb 2019.