{"id":600902,"date":"2024-04-10T13:57:50","date_gmt":"2024-04-10T17:57:50","guid":{"rendered":"https:\/\/www.rochester.edu\/newscenter\/?p=600902"},"modified":"2024-12-02T18:25:20","modified_gmt":"2024-12-02T23:25:20","slug":"emergency-care-ethical-dilemmas-600902","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/emergency-care-ethical-dilemmas-600902\/","title":{"rendered":"Exploring the ethical dilemmas of emergency care on the front lines"},"content":{"rendered":"

Rachel Whitmoyer brings her work as an emergency medical technician to bear on her philosophy studies at Rochester.<\/h2>\n
\"Rachel
MINDFUL MEDIC: <\/strong>As an EMT, Rachel Whitmoyer has helped countless patients facing dire situations. Those experiences prompted her senior thesis topic: an exploration of the biomedical ethical issues faced by EMTs. (Photo provided)<\/figcaption><\/figure>\n

As an emergency medical technician (EMT) since 2020, Rachel Whitmoyer \u201924 has helped countless patients facing dire situations. But she also has dealt with less-extreme scenarios, including one man who demanded transport to the hospital via ambulance because of . . . hiccups.<\/p>\n

That incident proved annoying and enlightening for Whitmoyer, a double major in physics<\/a> and philosophy<\/a> at the University of Rochester<\/a> who hails from Lebanon, Pennsylvania.<\/p>\n

\u201cIt\u2019s easy to become frustrated when the area you service is short on first responders and policy requires you to transport non-emergent patients to the hospital,\u201d she says. \u201cBut even if a patient isn\u2019t in need of immediate medical care, they may not have the background necessary to recognize that. They can be scared, confused, and stressed.\u201d<\/p>\n

Situations like this prompted Whitmoyer to dedicate her senior thesis to exploring the biomedical ethical issues faced by EMTs. \u201cSo much of health care emphasizes curing patients as a solitary goal,\u201d she says. \u201cBut high-quality patient care cannot exist without realizing that a patient is a person, and not a problem to be solved.\u201d<\/p>\n

Ambulances and academia<\/h3>\n

Whitmoyer\u2019s thesis focuses on a few points: justice considerations in triage and resource allocation in prehospital and hospital settings, the benefits that Emergency Medical Services\u2013initiated refusal of transport protocols have on individuals and communities, and why Do Not Resuscitate (DNR) orders outside of hospitals often don\u2019t honor patients\u2019 autonomy in end-of-life health care decisions.<\/p>\n

\u201cMy goal is to address how unyielding legal requirements have taken precedence over patient-specific care over the past few decades, and the potential solutions that would allow providers to maintain a balance of both,\u201d Whitmoyer says.<\/p>\n

Her research involves synthesizing the results from previous studies and analyzing them from an ethical perspective. \u201cFor instance, I\u2019ve been utilizing studies quantifying unnecessary ambulance use and studies discussing unwanted resuscitation attempts in patients with DNR orders,\u201d she says. \u201cBeing able to connect with subject-specific University librarians was extremely helpful in beginning the research process, as well as what I learned in my introductory writing and philosophy courses.\u201d<\/p>\n

Cases lacking genuine medical need can stretch limited resources and compromise the ability of EMTs to attend to genuine emergencies.<\/p>\n

Pennsylvania is one of 13 states that deem EMS an essential service<\/a> eligible for state funding. No one can be denied a ride to the hospital in an ambulance\u2014although not everyone needs it, hiccups or otherwise.<\/p>\n

\u201cPeople assume that they will get to the front of the line in the emergency department if they arrive in an ambulance,\u201d Whitmoyer says. \u201cThat\u2019s not true, unless they\u2019re in a cardiac or high-acuity situation. Anyone not facing a life-threatening situation usually has to wait.\u201d<\/p>\n

From EMT to physics and philosophy\u2014by way of the Rochester curriculum<\/h3>\n

William FitzPatrick<\/a>, the Gideon Webster Burbank\u00a0Professor of Intellectual and Moral\u00a0Philosophy at Rochester and Whitmoyer\u2019s thesis adviser, says she\u2019s \u201ca particularly impressive and ambitious student\u201d with an exceptional work ethic.<\/p>\n

\u201cCombining hard science, philosophy, and medicine is extraordinary, especially with the addition of a senior thesis project,\u201d he adds.<\/p>\n

FitzPatrick says Whitmoyer\u2019s thesis explores interesting and timely questions about how to balance deference to patient demands for emergency hospital transportation with professional judgment concerning genuine medical need.<\/p>\n

\u201cCurrent policy is weighted in favor of deferring to patient demands,\u201d he says. \u201cBut in cases lacking genuine medical need this can stretch resources and compromise the ability of EMTs to attend to genuine emergencies; on the other hand, refusal of transport in such cases raises its own problems unless the underlying social challenges and vulnerabilities are also addressed.\u201d<\/p>\n

Whitmoyer took classes with FitzPatrick in her sophomore and junior years and wrote a paper about the limitations of obtaining informed consent in medical emergencies. She so enjoyed doing the research and connecting it to her experiences as an EMT that she decided to take on an additional project this year to explore more of the ethical issues in pre-hospital emergency medicine.<\/p>\n

Whitmoyer entered the University as a physics major in 2020 but added philosophy as a second major her sophomore year. She says Rochester\u2019s flexible undergraduate curriculum made it possible to major in two non-related fields. \u201cGoing into my first semester and being able to choose classes and explore my interests gave me lots of flexibility,\u201d she says. \u201cI took some philosophy courses and just fell in love with it.\u201d<\/p>\n

One of the early impactful classes was Philosophy 105: Reason and Argument, with associate professor Zeynep Soysal.<\/p>\n

\u201cThat class taught me that learning how to construct a good argument makes it much easier not only to effectively communicate your ideas but also to analyze information coming from other sources,\u201d Whitmoyer says.<\/p>\n

Answering the call<\/h3>\n

Whitmoyer took an EMT class in high school and became certified in June 2020, when the COVID-19 pandemic was surging. She\u2019s affiliated with two companies back in Pennsylvania\u2014one paid and one volunteer\u2014and during summers she can work up to 60 hours per week. She usually works 12-hour shifts and always has at least one partner.<\/p>\n

<\/div>\n

The first step when responding to a call is determining the patient\u2019s level of consciousness and the reason EMTs were summoned. Whitmoyer may have to administer oxygen or medication or perform life-saving interventions to control high-acuity issues relating to airway, breathing, or circulation. The EMTs contact the hospital\u2019s emergency department via radio to alert them of their impending arrival and provide a patient care report that details pertinent findings or interventions performed.<\/p>\n

\u201cMy favorite part is getting to advocate for my patients and help mitigate stress in some of the most emotional moments of their lives,\u201d she says. \u201cI am often a stranger to many of the people I meet on scene and view it as an immense honor and privilege to be given their trust. Driving with lights and sirens on is pretty cool, too.\u201d<\/p>\n

Whitmoyer plans to pursue a career as an emergency medicine physician, which she will train for as she completes a military medical residency under the US Army’s Health Professions Scholarship Program<\/a> after graduating medical school.<\/p>\n

\u201cMy grandfather is an Army veteran, and many other family members have served,\u201d she says.<\/p>\n

Whitmoyer doesn\u2019t rule out continuing as an EMT long term, either.<\/p>\n

\u201cI\u2019d love to be able to pick up shifts if time allows,\u201d she says. \u201cThe work is so rewarding.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Rachel Whitmoyer \u201924, a double major in physics and philosophy, brings her work as an emergency medical technician to bear on her studies at Rochester.<\/p>\n","protected":false},"author":672,"featured_media":629972,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[9],"tags":[38462,21482,18662,16072,20932],"class_list":["post-600902","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-campus-community","tag-class-of-2024","tag-department-of-philosophy","tag-department-of-physics-and-astronomy","tag-school-of-arts-and-sciences","tag-undergraduate-research"],"acf":[],"yoast_head":"\nExploring the ethical dilemmas of emergency care on the front lines<\/title>\n<meta name=\"description\" content=\"University of Rochester undergraduate Rachel Whitmoyer is exploring the biomedical ethical issues faced by emergency medical technicians.\" 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