A phenomenological study exploring ethics in prehospital research from the paramedic’s perspective:

Experiences from the Paramedic-2 Trial in a UK ambulance service

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Abstract

Objectives
We set out to investigate paramedics’ views of ethics and research, drawing upon experiences from Paramedic-2, a randomised controlled trial comparing adrenaline and placebo in out of hospital cardiac arrest (OHCA).

Methods
An interpretative phenomenological approach was adopted. A purposive sample of paramedics (n=6) from North East Ambulance Service NHS Foundation Trust were invited to a semi-structured, in-depth interview.

Results
Three superordinate themes emerged: (1) morality, (2) emotion and (3) equipoise. Some viewed Paramedic-2 as an opportunity to improve OHCA outcomes for the many, viewing participation as a moral obligation; others viewed the study as unethical, equating participation with immoral behaviour. Morality was a motivator to drive individual action.
Positive and negative emotions were exhibited by the paramedics involved reflecting the wider view each paramedic held about trial participation. Those morally driven to participate in Paramedic-2 discussed their pride in being associated with the trial, while those who found participation unethical, discussed feelings of guilt and regret.
Individual experience and perceptions of adrenaline guided each paramedic’s willingness to accept or reject equipoise.
Some questioned the role of adrenaline in OHCA; others believed withholding adrenaline was synonymous to denying patient care.
Original languageEnglish
Number of pages6
JournalEmergency Medicine Journal
Volume36
Issue number9
Publication statusPublished - 19 Aug 2019

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Allied Health Personnel
Ambulances
Ethics
Out-of-Hospital Cardiac Arrest
Research
Epinephrine
Emotions
Moral Obligations
Research Ethics
Guilt
Patient Care
Randomized Controlled Trials
Placebos
Interviews

Cite this

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title = "A phenomenological study exploring ethics in prehospital research from the paramedic’s perspective:: Experiences from the Paramedic-2 Trial in a UK ambulance service",
abstract = "ObjectivesWe set out to investigate paramedics’ views of ethics and research, drawing upon experiences from Paramedic-2, a randomised controlled trial comparing adrenaline and placebo in out of hospital cardiac arrest (OHCA).MethodsAn interpretative phenomenological approach was adopted. A purposive sample of paramedics (n=6) from North East Ambulance Service NHS Foundation Trust were invited to a semi-structured, in-depth interview.ResultsThree superordinate themes emerged: (1) morality, (2) emotion and (3) equipoise. Some viewed Paramedic-2 as an opportunity to improve OHCA outcomes for the many, viewing participation as a moral obligation; others viewed the study as unethical, equating participation with immoral behaviour. Morality was a motivator to drive individual action. Positive and negative emotions were exhibited by the paramedics involved reflecting the wider view each paramedic held about trial participation. Those morally driven to participate in Paramedic-2 discussed their pride in being associated with the trial, while those who found participation unethical, discussed feelings of guilt and regret. Individual experience and perceptions of adrenaline guided each paramedic’s willingness to accept or reject equipoise. Some questioned the role of adrenaline in OHCA; others believed withholding adrenaline was synonymous to denying patient care.",
author = "Karl Charlton and John Franklin and Rebekah McNaughton",
year = "2019",
month = "8",
day = "19",
language = "English",
volume = "36",
journal = "Emergency Medicine Journal",
issn = "1472-0205",
publisher = "BMJ Publishing Group",
number = "9",

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T1 - A phenomenological study exploring ethics in prehospital research from the paramedic’s perspective:

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AU - Charlton, Karl

AU - Franklin, John

AU - McNaughton, Rebekah

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N2 - ObjectivesWe set out to investigate paramedics’ views of ethics and research, drawing upon experiences from Paramedic-2, a randomised controlled trial comparing adrenaline and placebo in out of hospital cardiac arrest (OHCA).MethodsAn interpretative phenomenological approach was adopted. A purposive sample of paramedics (n=6) from North East Ambulance Service NHS Foundation Trust were invited to a semi-structured, in-depth interview.ResultsThree superordinate themes emerged: (1) morality, (2) emotion and (3) equipoise. Some viewed Paramedic-2 as an opportunity to improve OHCA outcomes for the many, viewing participation as a moral obligation; others viewed the study as unethical, equating participation with immoral behaviour. Morality was a motivator to drive individual action. Positive and negative emotions were exhibited by the paramedics involved reflecting the wider view each paramedic held about trial participation. Those morally driven to participate in Paramedic-2 discussed their pride in being associated with the trial, while those who found participation unethical, discussed feelings of guilt and regret. Individual experience and perceptions of adrenaline guided each paramedic’s willingness to accept or reject equipoise. Some questioned the role of adrenaline in OHCA; others believed withholding adrenaline was synonymous to denying patient care.

AB - ObjectivesWe set out to investigate paramedics’ views of ethics and research, drawing upon experiences from Paramedic-2, a randomised controlled trial comparing adrenaline and placebo in out of hospital cardiac arrest (OHCA).MethodsAn interpretative phenomenological approach was adopted. A purposive sample of paramedics (n=6) from North East Ambulance Service NHS Foundation Trust were invited to a semi-structured, in-depth interview.ResultsThree superordinate themes emerged: (1) morality, (2) emotion and (3) equipoise. Some viewed Paramedic-2 as an opportunity to improve OHCA outcomes for the many, viewing participation as a moral obligation; others viewed the study as unethical, equating participation with immoral behaviour. Morality was a motivator to drive individual action. Positive and negative emotions were exhibited by the paramedics involved reflecting the wider view each paramedic held about trial participation. Those morally driven to participate in Paramedic-2 discussed their pride in being associated with the trial, while those who found participation unethical, discussed feelings of guilt and regret. Individual experience and perceptions of adrenaline guided each paramedic’s willingness to accept or reject equipoise. Some questioned the role of adrenaline in OHCA; others believed withholding adrenaline was synonymous to denying patient care.

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