Chapter 2 Understanding Law

Stephen Bartlett

2.0 Introduction

Chapter 2 Playlist

In the middle of autumn 2019, the English and Welsh Court of Protection found that a man incapable of understanding consent had the right to sexual relations. The man, autistic, with impaired cognition and in his mid-thirties, despite representing a moderate risk of sexual offending was, according the judge hearing the case, “entitled to make the same mistakes which all human beings can, and do, make in the course of a lifetime”. The judge said that insisting that JB (the person at the centre of the hearing) understands the issue of consent before being allowed to pursue sexual relationships would be discrimination because it would “impose on him a burden which a capacitous individual may not share”.[1] This decision on appeal from the court in the first instance was overturned by the Court of Appeal in a judgment published on 11 June 2020.[2] Despite the appeal being allowed, it was not without the Court of Appeal judges acknowledging the trial judge’s “strong commitment to the principle of autonomy, and the right of disabled people to enjoy life’s experiences to the full”.[3] Additionally, Lord Justice Baker stated “striking a balance between the principle that vulnerable people in society must be protected and the principle of autonomy is often the most important aspect of decision-making”.[4]

Until I read the background and the judgments, I had never really considered an individual’s right to make mistakes. I am not suggesting an apprehended sexual offence is reduced to a mistake. Some people have restrictions placed on them that prevents them from making mistakes – the removal by the state of opportunity for persons to make mistakes could be interpreted as being discriminatory. True equality is not limited to the laudable and quantifiably aspirational aspects of our existence. True equality means letting people experience life to their full: the good, the bad and the myriad of experiences in between. I had never thought of making a mistake as a privilege and this was another in a long line of occasions that I have had to check myself and accept I take a lot more for granted than I have any right. Fundamentally, these cases highlight for me how much I love the law. I love that there is an institution that engages with conflicts and overlapping issues daily. I love that the law can never takes itself for granted. Yes, it is flawed (remember my Dickens’ quote) but as an institution it is prepared to engage in introspection and wrestle and differ and herald new ways of thinking. Have you read Philip Pullman’s His Dark Materials or The Book of Dust? I’m not going to ruin it for you if you haven’t. But the fictional Dust is a bit like the law. It surrounds us without we ever knowing it is there. It’s like our shadow. And a more visible presence to some than to others. In sight but never in clear evidence unless we stand captured in the full glare of the law’s purview.

Governance in healthcare is huge. As paramedics you perform pre-shift vehicle checks, sign the drugs you are entitled to administer into and out of station, and so on. It is unlikely you feel the weight of the law on your shoulders. It’s there, it’s always there: Enterprise agreements; Workplace Health and Safety; Transport operations; Privacy, Confidentiality, Health, Drugs and Poisons, and on it goes. (Notwithstanding public health legislation, which I think everyone is supremely aware of now.) In short, we are governed from the moment we wake to the moment we sleep; incidentally, during that time too.

2.1 What is law and where does it come from? (I have no intention whatsoever of answering either of these questions, sorry. I just needed a title for this section.)

We have covered this already. I have introduced you to how morality can shape legislation (homosexuality, suicide and termination of pregnancy). Law must reflect the current demands of society and it must be a flexible enough instrument to adapt to societal changes. Contemporary Australia inherited its dominant system of governance from Great Britain. Principally, the common law and its adversarial judicial system, unlike other countries that adopted an inquisitorial legal system. Laws used to claim territorial rights in the 18th century continue to be at the centre of legal argument. Jurisprudence is the study of the theory of law and legal institutions. Where laws are derived from are a contested claim. Are laws the divine rights of kings? Are laws drawn from the natural world? Are laws man-made? What laws do we have today that we may not have in 10 to 15 years’ time? What laws do we need to ensure we remain part of this earth? Are laws the only method to govern conduct and behaviour?

2.2. Civil Law

Health and social care, two professional groups that commonly straddle the civil and criminal law. Both legal institutions are common features for people who work at the coal face of front-line health and social care. The most common area of civil law for our purpose is the law of torts. Torts and the common law make perfect companions (this is not to say that the law of tort only exists in the common law, Civil Liability Act 2003 (Qld) for example). As the range of civil wrongs deepen and broaden, the courts and this distinct area of law can adapt to change.[5] We will be visiting tort law in much more detail in part 2 but in the meantime its introduction serves as a backdrop to our overview of civil law. Civil law and criminal law can and sometimes do overlap. If you want a clean, but not entirely accurate division between civil and criminal law it’s this: criminal law – state responsibility; civil law – individual responsibility. By way of introduction we will look at civil law and criminal law separately.

In Australia, a complainant or claimant (UK) in legal proceedings is called a plaintiff and a person answering accusations of civil impropriety a defendant. In civil law, a defendant is guilty of the accused offence on the balance of probabilities. This means there could be some doubt to their guilt, but if it has been shown they committed the wrongdoing, they are accused of on the balance of probabilities. We will contrast this with the standard of proof in criminal proceedings in a moment.

The major areas in the law of tort relevant to us are:

  • Trespass to the person
    • o Battery
    • o Assault
    • o False imprisonment
  • Trespass to land
  • Negligence
    • o Good Samaritans

We will revisit this area of law many times throughout this unit. If you’re only go to take away one thing from this section let it be that the burden of proof in civil proceedings is based on the balance of probabilities that the alleged offence either occurred or did not occur.

Civil law and criminal law are not mutually exclusive. If a defendant is acquitted in the criminal system, claimants may be entitled to bring a civil claim. This happened in the trial of OJ Simpson for the murders (criminal law term)/wrongful death (civil law term) of Nicole Brown Simpson and Ronald Goldman. Simpson was acquitted of the murders of Nicole Brown Simpson and Ronald Goldman because the prosecution was unable to prove to a jury beyond all reasonable doubt (the standard of proof in criminal law) that he committed murder. However, Goldman’s family brought a civil proceeding against OJ Simpson and he was found guilty on the balance of probabilities of the claims made against him in the civil court. Unlike in the criminal courts, where getting sent to jail is a prospect of a guilty verdict, a common restitution in the civil courts is a plaintiff is awarded damages as recompense for the loss they suffered.

2.3. Criminal Law

Criminal law involves the laws of conduct that have been set by/for society (State of Qld). The burden or standard of proof in a criminal trial is beyond all reasonable doubt. This is a bedrock principle in adversarial criminal justice systems. It is the prosecution’s role to demonstrate beyond all reasonable doubt that the defendant is guilty. Whereas, it is the defence team’s role to demonstrate that the prosecution’s case does not prove beyond all reasonable doubt their client’s guilt.

The Criminal law in Queensland is covered by the Criminal Code Act 1899 (Qld).[6] We will return to the criminal code when we look at specific offences. The Criminal Code Act 1899 (Qld) covers crimes (serious indictable offences (trial by jury)); misdemeanours (less serious indictable offences (trial by jury)) – both indictable offences – and simple or summary offence (may be convicted summarily by a Magistrate)). Just to clear up any misunderstanding, they’re all crimes. It is just that some crimes are not as serious as other crimes and do not need to be treated in the same way. For example, low order offending like engaging in disorderly behaviour will not be heard by a jury.

A crime generally requires a person to have the intention to carry out a guilty act – the mens rea – and the committable guilty act (this can include an omission: not doing something. For example, not providing someone with the necessities for life leading to their premature death) – the actus reus. Also, a person may not intend a certain outcome but their act or omission, but they may be reckless in their disregard. Here’s a quick example:

The criminal law has several features. These are:

  • Parties to a criminal matter
  • Initiation of the action
  • Elements of a crime
    • o Each criminal offence is broken into several elements. The evidence must demonstrate that each element has been satisfied.
    • o Example, Theft:
      • (i) the removal of an object,
      • (ii)the property of another,
      • (iii) with intent to permanently deprive the owner of the object.
    • Standard of proof
      • o The prosecution must, with the evidence available, prove “beyond reasonable doubt” that each element of a crime has been satisfied.
    • Presumption of innocence
      • o A fundamental principle is that innocence is to be assumed until proven otherwise. An accused person is presumed innocent until proven to be guilty of a crime.
    • Liability rests with the accused
      • o Unlike civil matters (vicarious liability), the liability for a criminal offence rests with the accused only – no other person can assume responsibility or liability for the criminal acts or omissions of another.

In addition to the items listed above, an important feature of law is the availability of defences. By now you are aware that HCPs can claim lawful justification for some conduct performed in the course of their work. Deprivation of liberty is both a criminal offence and a civil offence (false imprisonment). The Mental Health Act 2016 (Qld) and the Public Health Act 2005 (Qld) provides lawful justification to treat and transport patients without first obtaining their consent. Deprivation of liberty, which a fundamental principle enshrined in the Human Rights Act 2019 (Qld) is permitted when the detention or restraint is justified. It is necessary to protect the patient (in the patient’s best interests) and is applied in accordance with prescribed guidelines (agency policies and procedures). Or, it is necessary in order to protect others (other patients or persons in the area and HCPs) using the minimal force required.

2.4 Statutory Interpretation

A little word on statutory interpretation. And it is a little word. Whole books have been written on this technical topic. Screeds of paper have been devoted to the ‘width’ of words. Words have elastic properties. They can be interpreted narrowly, or they can be interpreted widely. Think of the word ‘rain’. Rain is nuanced. It can be heavy or light. It can water the yard, or it can cause devastation. Statutory interpretation requires an understanding of impact and intention. Words are important. They convey meaning. They provide instruction. They also provide confusion, misunderstanding and misdirection. Certainty is not always possible in legislation. Not that legislation is written ambiguously deliberately. Two people reading the same section from the same act may interpret it differently. As we will go on to learn, misunderstanding legislation is common. Common sense is held to be the best approach to interpreting legislation. You could also argue from a variety of perspectives that share the view legislation should be interpreted in the least restrictive way possible. Additionally, acts overlap with other acts. Take capacity for example. The test for capacity in Queensland is found everywhere except the one act where you need it to be. HCPs don’t have time to develop a rigorous knowledge of the law. In many cases, non-lawyer medics will take aim, fire their arrow first and hurriedly move their target in the general direction the arrow is likely to land. Perhaps this is where the term defensive practice comes from? Lawyers and physicians could learn a great deal from one another.

2.5 Courts

We have already covered the court hierarchy in Australia. This section I will discuss the following:

  • Health providers in court
  • Appearance in court
  • Command to attend
  • Sequence of a trial (criminal and civil)
  • Giving evidence in court

If you stay working as a HCP, and a bold claim here: this is more in relation with paramedics than nurses, you will have to provide evidence to either a coronial inquest, a criminal trial or a civil trial. Appearing and providing evidence in court is not something that comes easily to most of us. It can be daunting, but despite this, it needn’t be. However, if called to provide evidence you will need to be prepared. If you’re not, then this could be you:

If called to appear in court, it will be for one of the following reasons:

  • Relating to a case in which you attended or were involved in some other way;
  • Expert evidence (opinion based upon knowledge and expertise).

You will either be summoned to attend court or summoned to produce documents which will assist the court in their deliberations. The attendance of a witness to appear and give evidence, or to produce documents, can be enforced by way of:

  • Writ of Subpoena (District & Supreme Courts)
  • Summons to Attend (Magistrate Court)
  • Notice to Attend (Coroners Court)

A subpoena is a document issued by the relevant court. It is a court order which compels the person named therein, to attend court to give evidence and/or produce documents identified in the subpoena. There are two types of subpoena:

  • Subpoena ad testificandum:
    • o Compels the person to attend court and give oral evidence
  • Subpoena duces tecum:
    • o Compels the production of documents identified therein

Issuing a subpoena must follow rules. A subpoena is to be personally served upon the person to who it is addressed; it is to be accompanied by ‘conduct money’ if relevant, and; it must be served within a ‘reasonable time’ before required to attend.

2.5.1 Court Appearance

Depending on the court you are compelled to attend, the process will differ. All criminal cases and most civil cases are conducted using an adversarial system: facts are presented followed by a series of questions and answers posed to witnesses by each party to the proceedings. Contrast this with the inquisitorial system where a judge poses questions to witnesses at his/her discretion to establish what happened. This system is used in France and Scotland (the Auld Alliance) but it can also be found in the coronial system of inquiry. The role of the coroner is to establish how a person died, not apportion blame for the death. However, a coroner reserves the opportunity to refer findings to criminal and/or civil court systems as part of their respective judicial processes.

Sequence of a Trial



Selection of the jury panel Opening statement (Plaintiff)
Arraignment of the accused Examination; cross-examination; re-examination of Plaintiff’s witnesses
Opening statement (Prosecution) Opening statement (Defendant)
Examination; cross-examination; re-examination of prosecution witnesses Examination; cross-examination; re-examination of Defendant’s witnesses
Opening statement (Accused) Closing statement by Defendant
Examination; cross-examination; re-examination of defence witnesses Closing statement by Plaintiff
Closing statements by accused and prosecution Judgment (can be reserved and delivered at a later date)
Directions to the jury (Judge or tribunal of law)
Jury (tribunal of fact) consider evidence
Jury delivers verdict
If guilty verdict, date set for sentencing

If called as a witness, the process may look like the following:

  1. Witness is to remain outside the court until called
  2. Telephone and video evidence is possible if pre-arranged and agreed by all parties. Witness must be available at the designated telephone number or location of video technology (usually another court). Failure to do so may result in contempt.
  3. When called to give evidence, the witness is to swear an oath or make an affirmation
  4. Examination-in-chief
    • The purpose of examination-in-chief is to enable the party who has called the witness to put the evidence before the Court through a medium of questions and answers, and presentation of other evidence such as documents authored by the witness.
  5. Cross-examination
    • The witness is questioned regarding evidence provided during evidence-in-chief and other matters if deemed relevant (professional qualifications). Purpose of cross examination is to test the evidence; scrutinising the memory; credibility (honesty) and reliability of a witness.
  6. Re-examination
    • The purpose is to clarify and correct any matters which arose during cross examination.
  7. Witness excused

If daunted by the prospect of giving evidence in court, it will be helpful if you are prepared and can familiarise yourself with court proceedings. Before you appear in court you will need to review any relevant documents beforehand; clarify with legal representatives the reason for your appearance; observe court etiquette and rules; answer all questions honestly; only answer the questions asked (it’s okay to ask for the question to be repeated to insure you understand what is being asked); answer all questions with a verbal response and speak clearly (recordings). Finally, do not use jargon or abbreviations. Here’s why:

2.5.2 Rules of Evidence

Now onto evidence. Evidence given in court is broken down into direct evidence and indirect or circumstantial evidence. Direct evidence is evidence which is directly relevant to the case or an element of the case. The witness has seen or perceived this evidence with his/her own senses and has done so firsthand. Indirect or circumstantial evidence is evidence from which inferences may be drawn. An explanation that may connect a series of established facts. One fact is used to prove the existence of another.

Additionally, you may be familiar with the terms opinion or hearsay evidence. These types of evidence are not usually admissible in court. The rule for opinion evidence finds it is for the jury to form opinions and draw inferences and conclusions, and not for the witness. The witness brings to the jury, the raw material of fact on which their minds work. There are exceptions, however. These are:

  • Expert witness:
    • o Academic qualifications and practice in the relevant area form the basis upon which an expert may express an opinion
  • Quasi-expert witness:
    • o Vocational training, practice and experience may qualify opinion
  • Lay person:
    • o Repeated observations and everyday experiences may qualify a person to arrive at an opinion

Hearsay is an assertion, either oral or written, which is made by a person other than the witness who is giving evidence. It is second-hand knowledge i.e. paramedic recalling a statement made to them paramedic by a bystander. Hearsay is not admissible, that is, it cannot be admitted into evidence. Unless they are:

  • Statements of deceased persons
    • o To paramedic
  • Adverse admissions made by parties to the proceedings
    • o Accused made an admission to paramedic or EMD
  • Confessions made by an accused person in a criminal proceeding
    • o To police
  • The Doctrine of Res Gestae
    • o Statements by patient
  • Contextually relevant
  • Statutory exceptions
    • o Sections 92(3), 93B, 93C Evidence Act 1977 (Qld)

The doctrine of Res Gestae refers to statements that are an integral part of the incident and seek to explain relevant acts. For example, information provided by a patient that resulted in the paramedic taking a course of action. It also applies to statements made by the maker concerning his/her contemporaneous physical sensations/state of health/state of mind/emotion. For example, a statement by a patient: ‘I can’t breathe’ or ‘I have pain in my chest’.

2.6 The Coroner

The Coroners Act 2003 (Qld) details the role and the powers of the coroner in Queensland; it establishes the position of the state coroner. The functions of the coroner are to hold inquests into reportable deaths and help to prevent future deaths by allowing coroners at inquests to comment on matters connected with deaths, including matters that relate to public health and safety and the administration of justice. Section 8 Coroners Act 2003 (Qld) defines what a reportable death:

(1) A person’s death is a reportable death only if the death is a death to which subsection (2) and subsection (3) both apply.

(2) A death is a reportable death if—

(a) the death happened in Queensland; or

(b) although the death happened outside Queensland—

(i) the person’s body is in Queensland; or

(ii) at the time of death, the person ordinarily lived in Queensland; or

(iii) the person, at the time of death, was on a journey to or from somewhere in Queensland; or

(iv) the death was caused by an event that happened in Queensland.

(3) A death is a reportable death if—

(a) it is not known who the person is; or

(b) the death was a violent or otherwise unnatural death; or

(c) the death happened in suspicious circumstances; or

(d) the death was a health care related death; or

(e) a cause of death certificate has not been issued, and is not likely to be issued, for the person; or

(f) the death was a death in care; or

(g) the death was a death in custody; or

(h) the death happened in the course of or as a result of police operations.

A death in care is defined by s 9 Coroners Act 2003 (Qld) as:

  • The deceased had a disability under the Disability Services Act 2006 (Qld) and was living or receiving services in/from a level 3 residential service
  • The deceased was a forensic disability client under the Forensic Disability Act 2011 (Qld)
  • The deceased was being taken to, or detained in, a place that is an authorised mental health service or under an emergency examination order under the Mental Health Act 2016 (Qld)
  • The deceased was a child placed in care under the Child Protection Act 1999 (Qld)
  • Person was under the guardianship of the chief executive under the Adoption Act 2009 (Qld).

A coronial investigation is undertaken to establish:

  • the identity of the deceased;
  • when the person died;
  • where the person died;
  • the medical cause of death; and
  • the circumstances in which the death occurred.

Section 27 Coroners Act 2003 (Qld) states that a coroner investigating a reportable death must hold an inquest if:

(1) The coroner investigating a death must hold an inquest if—

(a) the coroner considers the death is—

(i) a death in custody; or

(ii) a death in care, in circumstances that raise issues about the deceased person’s care; or

(iii) a death mentioned in section 8(3)(h) that is not also a death in custody, unless the coroner is satisfied the circumstances of the death do not require the holding of an inquest; or

(b) the Attorney-General directs the State Coroner to arrange for an inquest to be held into the death; or

(c) the State Coroner, on the State Coroner’s own initiative or on an application under section 30, orders an inquest be held into the death; or

(d) the District Court, on an application under section 30, orders an inquest be held into the death.

Section 28 Coroners Act 2003 (Qld) states that a coroner investigating a reportable death may hold an inquest if:

(1) An inquest may be held into a reportable death if the coroner investigating the death is satisfied it is in the public interest to hold the inquest.

(2) In deciding whether it is in the public interest to hold an inquest, the coroner may consider—

(a) the extent to which drawing attention to the circumstances of the death may prevent deaths in similar circumstances happening in the future; and

(b) any guidelines issued by the State Coroner about the issues that may be relevant for deciding whether to hold an inquest for particular types of deaths.

Coronial inquests are generally convened in local Magistrates’ Courts in the jurisdiction where the death occurred. A police officer or lawyer may assist the coroner by organising and bringing evidence before the coroner. A person may seek leave (permission) to appear at the inquest to examine witnesses and make submissions, if deemed to have sufficient interest in the matter. This may include a family member, a government department, a manufacturing company of a produce believed to be related to the death.

A person can be compelled to appear and give evidence before the Coroners Court (Order to Attend). In the event there is a failure to comply to comply with this lawful direction, the Court may issue a warrant for the person’s arrest. The Coroners Court is not bound by the rules of evidence and may inform itself in any way it considers appropriate. A witness may be required to give evidence that could incriminate him/her (if in public interest to do so). Incriminating evidence provided to the Coroners Court is not admissible against the witness in any other proceedings.

Section 45(5) Coroners Act 2003 (Qld) explicitly prohibits a coroner from making statements that a person is guilty of an offence or civilly liable for something. However, s 46 Coroners Act 2003 (Qld) permits a coroner to comment on public health or safety, the administration of justice and importantly for health and ambulance services, communicate ways to prevent deaths from happening in similar circumstances in the future.

Here are two links. The first is the State Coroner’s findings into the death of Nola Jean Walker; the second is the State Coroner’s findings into the death of Gregory David Van Moolenbroek. These are examples where it is likely the coroner made recommendations to prevent similar deaths occurring in the future. Most of you will be familiar with the death of Ruby Yan Chen. The findings from this inquest was influential in changing practice in the Queensland Ambulance Service.

2.7 The Ambulance Service Act 1991 (Qld) and the Health Practitioner Regulation National Law (Queensland)

There are a couple of pieces of legislation that will keep cropping up in the Pressbook and the unit. The first is the Ambulance Service Act 1991 (Qld). It is responsible for the QAS to be a statutory body with responsibilities stated in the Act. For front-line paramedics, section 38 Ambulance Service Act 1991 (Qld) outlines the powers they have bestowed on them under the auspices of the Act:

38 Powers of authorised officers

(1) An authorised officer, in providing ambulance services, may take any reasonable measures—

(a) to protect persons from any danger or potential danger associated with an emergency situation; and

(b) to protect persons trapped in a vehicle, receptacle, vessel or otherwise endangered; and

(c) to protect themselves or other officers or persons from danger, potential danger or assault from other persons.

(2) Without limiting the measures that may be taken for a purpose specified in subsection (1)(a) or (b), an authorised officer may, for that purpose—

(a) enter any premises, vehicle or vessel; and

(b) open any receptacle, using such force as is reasonably necessary; and

(c) bring any apparatus or equipment onto premises; and

(d) remove from or otherwise deal with, any article or material in the area; and

(e) destroy (wholly or partially) or damage any premises, vehicle, vessel or receptacle; and

(f) cause the gas or electricity supply or motor or any other source of energy to any premises, vehicle, vessel or receptacle to be shut off or disconnected; and

(g) request any person to take all reasonable measures to assist the authorised officer; and

(h) administer such basic life support and advanced life support procedures as are consistent with the training and qualifications of the authorised officer.

(3) Without limiting the measures that may be taken for a purpose specified in subsection (1)(c), an authorised officer may, for that purpose, require any person not to enter into or remain within a specified area around the site of the danger to a patient. [7]

We will return to this section a lot. I include it here as an example of statutory powers permitting QAS paramedics to do tings that they ordinary civilian cannot in the course of paramedic-ing (another example of questionable verb usage). The other grosse affaire is the National Law applying to all HCPs in Australia. Again it will be a common theme in this unit [8]. For some this piece of legislation is a big stick to hit you with. For others, it is the pinnacle of patient safety. I’ll leave it up to you to decide. More on it next chapter.

2.8 Final Thoughts

Oh, I know it’s dry. I know it’s not what you think you need to know to be an affective HCP. How to help, how to do stuff, how to paramedic (I doubt this is a verb, but you get the idea) and how to nurse. Please believe when I say it is, I talk from experience. Now you know all about law and ethics as it relates to being a HCP. In the next chapter we’ll look at professionalism and the regulatory body.

2.9 Case Study

Alex and Lloyd (a recently graduated university graduate in paramedic science) have been dispatched to ballistics injury, multiple victims to a remote and rural area. They have been called by the local police service. It takes them 24 minutes to arrive on scene. On arrival, they are met by a very pale police officer who is sweating profusely, he is, the crew note, carrying a sawn-off shotgun. Alex, performing patient care, thinks, judging by the police officer’s presentation that he is a patient and begin to assess him. The police officer looks in disbelief at Alex and in no uncertain terms, asks him what he is doing, ‘John’s around the corner; he’s shot in the leg. He’s next to the perpetrator’. The police officer takes Alex and Lloyd to John, the injured police officer. The police officer has his gun drawn and pointed at a heavily built male lying in a collapsed state. As he brings the paramedics to the location of the injured party/parties he assures them he will maintain scene safety. He states that the only ones armed on scene are the police officers. As they approach, they identify John who is sitting on the ground. He is pressing what appears to be a piece of material against the upper aspect of his left thigh. The left trouser leg of his police uniform is torn and covered in blood. In the injured police officer’s right hand he is holding his police issued Glock 9mm and is pointing it at an apparently motionless heavily built male. He lies in the porch area of a mobile home; the porch area is lit. The first police officer’s leaves the scene saying that he is going to get back-up. Alex asks the police officer to also request the police dispatch to contact ambulance dispatch and request another unit to this location, ‘two patients require urgent treatment’.

Alex treats John who, despite his injury, is haemodynamically stable, his bleeding is controlled. Lloyd attends to the heavily built male. His condition is far more serious. He appears to have sustained a ballistic injury to his abdomen. He has a rapid, weak and thready pulse, and is also extremely hypotensive; he is diffusely sweaty and his breaths are rapid and shallow. The heavily built male says to Lloyd in a guttural rasp, ‘they done me’. Lloyd runs over to Alex to tell him about the gravely ill patient; as he does John asks Lloyd about the injured heavily built male. Lloyd says that he needs urgent hospital treatment. John states that he and Phil (the police officer Alex and Lloyd first encountered on scene) were called out to this location to arrest Gordo Kilbane on the grounds of storing and distributing sexually explicit electronic images of minors, ‘he came out firing, he got me, then Phil took him down’. Phil arrives back on scene and states that back up is on the way. Lloyd enquires about the second ambulance. Phil says, ‘nah, mate. They can’t get one to you and dispatch tells me that there is a storm cell on the way, and they won’t be able to get a helicopter out to you either’. Lloyd says, ‘we will have to transport both patients to hospital’. John says, ‘there is no way I am going to travel in an ambulance with that paedo scum, leave him to rot’.

Taking Gordo to hospital will save his life; leaving Gordo at scene will result in his death following the gun shot injury to his abdomen. John’s injuries will heal, and he will not suffer long term damage. What to do? What to do indeed?

2.10 Recommended reading

Moritz, Dominique (ed), Paramedic Law and Regulation in Australia (Thomson Reuters (Professional) Australia, 2019) pp 3-16; 67-85; 87-103

  2. A Local Authority v JB (Rev 1) [2020] EWCA Civ 735
  3. A Local Authority v JB (Rev 1) [2020] EWCA Civ 735 at 105
  4. A Local Authority v JB (Rev 1) [2020] EWCA Civ 735 at 98
  5. Harriton v Stephens (2006) 226 CLR 52 at 151 per Kirby J.


CSB338 Ethics and the Law in Health Service Delivery Copyright © by Stephen Bartlett. All Rights Reserved.

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