Fire Science and Engineering (한국화재소방학회논문지)

Korean Institute of Fire Science and Engineering (한국화재소방학회)
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Perceptions about the Professional Ethics of EMT

응급구조사 직업윤리에 대한 인식조사

  • Yun, Hyeong-Wan (Department of Emergency Medical Technology, VISION University, College of Jeonju) ;
  • Lee, Jae-Min (Department of Emergency Medical Technology, Gwangju Health University)
  • 윤형완 (전주비전대학교 응급구조과) ;
  • 이재민 (광주보건대학교 응급구조과)
  • Received : 2013.11.26
  • Accepted : 2014.02.14
  • Published : 2014.02.28
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Abstract

Complex ethical issues of Emergency Medical Techinician (EMT) out-of hospital emergency medical scene and the ER (Emergency Room) behaviors were studied. The survey was conducted by 500 EMT group members working in the field of ambulance work and general hospital and it was about their work ethics, discussions and solutions about the transferred patients, and ethics regarding Do Not Attempt Resuscitate (DNAR). The survey includes work ethics, awareness about the target job, a discussion on the transfer of patients, measures, and deathbed. Discussions about the patient's condition and diagnosis results were majorly absent during patient transportation at the emergency care scene. More than 90% of emergency care transfer were inappropriate. Sometimes, EMT working in the field facing morally unethical problems beyond their responsibility. When EMT, who can not make death diagnosis, received deathbed related DNAR issues, they gone through severe ethical conflicts. The institutional support and therapy for EMT was weak. In Korea, especially in the accident site, ethical issues education is more needed than DNAR prevalence of education and guidance. If ethics training and guidance are given to EMT, a lot of moral errors in the field can be resolved.

응급구조사는 병원 밖 사고 현장과 응급실의 응급의료 행위에 대해서 복잡한 윤리적 문제가 야기된다. 소방현장 및 종합병원에서 근무하는 응급구조사 500명을 대상으로 직업윤리의식과 태도, 이송한 환자에 대한 논의와 대책 그리고 임종에 관한 윤리의식을 설문하였다. 직업윤리의식과 태도, 이송한 환자에 대한 논의와 대책 그리고 임종관련에 대한 윤리의식을 설문해 보았는데 직업적 윤리의식이나 응급구조사가 가져야 할 태도가 높게 나타났다. 현장에서 응급처치나 이송한 환자에 대해서 결과를 논의하거나 예후를 알아보는 군은 자격에 따라 유의하게 나타났다. 부적절한 응급처치나 이송에 대해서는 90% 이상이 토론 후 대책을 세우는 것으로 보여 졌으나, 지난 업무에 대해서는 그냥 넘어가기를 원하는 것과 책임문제로 상관에게 보고하는 경우도 있어 도덕적으로 비윤리적인 문제도 안고 있었다. 사망진단을 내릴 수 없는 응급구조사에게 임종관련 DNAR 문제로 윤리적 갈등을 심하게 겪고 있는데, 제도적 뒷받침이 미약하여 불필요한 치료를 하고 있다. 사고현장에서 윤리적인 문제들, 특히 DNAR 교육은 필요성에 비해 교육과 지침서의 지급률이 지역과 소속마다 차이가 심하였다. 따라서 응급구조사의 직업윤리교육과 지침이 반드시 필요하며, 응급현장에서 이용 시 많은 도덕적 오류들이 줄어들 것이다.

Keywords

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