Paramedics and public health emergencies: Is there a 'duty to respond' in Australia?: Smith, Burkle Jr, Woodd, Jensen, and Archer examine the concept of 'duty to respond' in the Australian SARS context

As evidenced by Toronto's experience with Severe Acute Respiratory Syndrome (SARS), paramedics provide an integral 'frontline' role during a public health emergency. During normal operating procedures paramedics understand their 'duty of care' to individual patients. However, is there a 'duty to respond' when the point of care moves from the individual patient to the greater population during a public health emergency? An extensive search of publicly available state and national legislation and regulations was conducted to examine the concept of 'duty to respond' in the Australian context. Relevant Emergency Management Acts, Health Acts, and ambulance service regulations lacked a clear focus on 'duty to respond' and failed to address the ramifications of paramedic refusal to work. As Australia is a Common Law Country the issue of duty to respond could be managed through paramedics' individual employment contracts with their respective ambulance services, and failing to respond could potentially be addressed using pre-existing standard terms and conditions for employment. This issue is particularly topical in light of the current public health challenge posed by the Swine Influenza pandemic.