Ethical aspects play a universal role in every phase of the chain of survival. Already during legislation, the stage is set for the basic setup of a rescue system. Response times, safety level and other parameters define the efficiency of the system. Furthermore, the specifications of the technical and pharmaceutical equipment level and the level of qualification of the personnel will have a great impact on the quality of the service. Another crucial role has the dispatch centre and the underlying dispatch strategies, which influence the accessibility and allocation of resources. Decision-making under a high time pressure lies in the nature of emergency missions. There is a wide range of situation when ethical considerations a relevant: This may be a “go-or-not-to-go” decision, when there is a risk for rescuers or triage situations in mass casualty incidents. There a different approaches to solve these ethical questions, which include the creation of, a: societal consent for what is adequate in the regional or institutional context or the use of standard operating procedures and algorithms that define certain decision corridors. For the development of the systems and decision processes, it is crucial to have viable data to analyse and improve the performance of the emergency medical services.

About the author

Stephan Prückner (MD) specializes in Anaesthesiology, Emergency Medicine, and is the head of disaster control and civil protection as well as the head of pandemic management at the LMU Klinikum. As managing director of the Institut für Notfallmedizin und Medizinmanagement at Munich’s LMU Klinikum he leads an interdisciplinary team of scientists and researchers analysing the Bavarian EMS data and is thus in charge of optimizing the Bavarian EMS. The institute is home to a state of the art simulation centre for human factors training in medicine. From 1998-1999 he was a Research Fellow/Research Associate at the University of Pittsburgh Medical Center on a US-Navy Research Grant. From 2007-2009 he was a research associate for EU/BMBF-Projects EMERGE, OASIS, ROSETTA, and BMBF-Project ProAssist4Life at the Institute of Anaethesiology and Emergency Medicine, Westpfalz-Klinikum, Kaiserslautern. This year marks his 20th anniversary as an emergency physician with the well-known rescue service AirZermatt (Switzerland) where he is on active duty a few weeks each year. From 2009 – 2013 he was head of the Airborne EMS division at Klinikum Großhadern and continues his work as an airborne emergency physician. As chair of several medical associations, his scientific focus is on primary- airborne EMS, pre-hospital care, social aspects and the epidemiology of EMS.