Emergency Medicine and Ethics

Emergency care is one of the most sensitive and unique areas of health care. This specialty is commonly based on a combination of some factors such as urgency, crowding, difficulties in decision-making process, do-not-resuscitate (DNR) orders, family presence during resuscitation, patient communication, and triage. In-hospital or prehospital, many emergency situations are sudden, unexpected, agonizing and at times life-threatening conditions. All these specialties are also related to ethics and ethical decision-making in a limited time.

Moreover, frontline health care providers such as emergency physicians, nurses, paramedics are essential to maintain the functioning of the health care system, especially during crises and disasters. Thus, emergency medicine is one of the areas where an institutional structure of the health care system are most visible. This particular structure is not independent of basic values such as human rights and ethics.

Ethics is the application of values and moral rules to human activities. Bioethics, a subset of ethics in medicine and biology, deals with relationships between practitioners and patients, practitioners and society, and society and patients. Emergency medicine is in a very special position in ethical issues for three reasons; urgency, limited time for any decision, and health care providers are mostly alone when decision-making. In addition, many other components such as religion, law, rights, society, and culture are subject to engagement in ethical discussions. Because of all this, there are many ethical conflicts unique to emergency medicine, such as patient autonomy, decision-making capacity of the patient, consent, surrogates, refusal of treatment, withholding or withdrawal of CPR, confidentiality, distributive justice, triage, dying in dignity, truth-telling, caring minor,and more.

We encourage clinicians, bioethicists, and researchers interested in this topic to submit their articles. Reviews, original articles, and case reports are particularly welcome. Also, we warmly invite you to submit theoretical papers related to emergency medicine and ethics.