Rules, shmules...

[johnponz]

I was a medic in the Army many moons ago so I would be pretty comfortable giving an Epi injection in the situation. As Beavah said the chances of an unfavorable outcome are not that great.

 

However a bee sting for someone that is allergic can be quite fatal quite quickly. This is definitely an emergency case. Some people do not realize how dire this can be and how quickly. It is no joke.

 

I guess it is the same with imminent program failure. I too would throw the book away in that case, but then work to get back to normal. It is not normal and very stressful to always be working as if it is an emergency.

 

In the case of the allergic kid, how would you feel if after this incident, he failed to bring his epi pen ever again knowing that the allergic adult had one he could use.

 

This is analogous to the Unit leader, District or Council who continue to use Unit Leaders as commissioners when the emergency is over. They do this because it is easier than recruiting non-unit leaders. Those leaders need to stop taking the easy way out and find non-unit leaders who can do just as good of a job.

 

 

(This message has been edited by johnponz)

[Beavah]

Yah, SeattlePioneer, but da point is still the same regardless of my trainin'. I'm breakin' the rule. The fact that yeh don't think based on your experience that you'd do the same thing is a judgment call based on your assessment of your own ability, not based on "da rule." I'd expect yeh to make the same assessment with respect to a swimming rescue or runnin' into a burning building, when there's no "rule" involved.

 

Generally speakin', johnponz, I agree with yeh. The guidance we should offer generally is the guidance for "ordinary" cases, not for exceptions. I think personally we should offer some alternatives, because there is more than one "ordinary" case out there, eh? Small troops, big troops, etc. But yeh don't set the guidance for da exceptional cases.

 

So yep, I think and recommended that in ordinary cases in a reasonable sized district, commissioners shouldn't hold unit leader positions in units. In fact, I prefer commissioners not to hold any unit positions, and I try to get new ones to go spend some time with units that do things a lot differently than their unit of origin. They need to get some experience with da range of practice out there before they can be effective as commissioners.

 

I am, sad to say, one of da rarer, more eccentric critters in da commissioner service.

 

Beavah

 

[Eagle92]

One of the challenges I see with these laws i and the question of "level of training" is the fact that first aid procedures do change over time. So if you are in a situation where the current training does not cover the problem, but your 10,15, 20+ year training does cover it, which standard are you held to?

 

Give you a good First Aid example. Back in my day Serious bleeding was "direct pressure, elevation, pressure point, tourniquet." The I was taught " direct pressure, elevations, pressure point, pressure ball, pressure bandage, tourniquet." Not much difference.

 

BUT then they did away with the pressure balls and tourniquets. I can understand why pressure balls, same thing as packing bandages over the wound. But the reason for no more tourniquets was that to many people were using them improperly and making matters worse. So they stopped teaching it.

 

But now, it's direct pressure, add more dressings and pressure, pressure bandage, tourniquet. Now the question I have for the legal Beavah is this: if something was to happen pre-2011 when tourniquets came back in training, if I was to use one and something happened, would I be held liable? I was trained in their use, but the current cert I had at the time of the incident didn't cover it?

 

Or I'll give you a real life scenario that happened to me. Kid is drowning and I respond to it without any rescue equipment as I was not only trained to do when I first became a lifeguard many moons ago, but also trained others to do when I was first a lifeguard instructor. But since the last cert I had and taught did not teach them. If something was to happen, would I be liable? I am no longer a certified lifeguard, so ignoring the drowning person is now an option for me.

 

 

 

 

[Beavah]

Yah, I think da point of da thread is who cares what the law is?

 

If yeh have a lad in need of care, yeh care for him to the best of your ability. If there's a fellow citizen in distress, yeh help other people at all times to the best of your ability.

 

We do that because it's the right thing to do. We teach scouts to do that because it's the right thing to do.

 

The fundamental public policy issue is that the law should not in any way discourage citizen responders from renderin' aid to the best of their ability.

 

There's really nuthin' more to it in my mind. Don't worry your head about legal sharks or legal Beavahs. Just do what's right.

 

Beavah

 

[acco40]

I think it boils down to when one sees a person who needs help do you think of yourself first or the other person?

[Beavah]

Nope, we're not assumin' anything.

 

Any time anyone attempts to assist another person, there is a risk of harm. Every treatment by a medical professional carries with it a risk of harm, eh? Even under ideal conditions. Why should it be any different for a civilian responder in far less than ideal conditions?

 

All that anyone expects is that yeh will do your best, and use sound judgment.

 

If a lad in the water is experiencing stress and is at risk of drowning and yeh happen to have a throw rope, there is a very real (but small) possibility that if yeh toss him the rope, his struggles and the current will cause it to wrap around his body or his neck and cause him to die. We lost a scout that way in Washington state a few years back. Ropes in the water have some real risks.

 

That real risk does not mean that as a scouter yeh don't throw the boy the rope.

 

Seein' da symptoms of anaphylaxis result from a witnessed bee sting I'm faced with da pain and suffering and possible long-term health risks or death of a child in front of me. Good judgment demands that I discount the remote risk that the lad has an undiagnosed heart condition or some other rare thing that might be worsened by the medication. Like throwin' the rope, it's a remote risk vs. an actual acute crisis.

 

Yep, if yeh don't know enough to be able to make that (relatively obvious) judgment, then yeh shouldn't act. Da question in my mind would be why in the world yeh took a lad out into the woods or out on the water without da skills and judgment to be able to act appropriately? Why weren't yeh prepared?

 

When we say we followed da rules because we didn't know any better, it always begs da question of why we didn't know any better.

 

So from OakTree's list, that's J2, J10, J12, J16

 

Beavah

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[SeattlePioneer]

>

 

 

The hypothetical I proposed was that a person applied a tourniquette when it wasn't needed, which caused an arm or leg to be amputated.

 

Somehow I don't think the parents of the one armed boy are going to be saying "Thank you!"

 

 

But if you want to lay your hands on someone's kid to do medical intervention you aren't trained to do, help yourself. I'm simply saying that's not something I would do myself.

 

 

>

 

 

Throwing a drowning person a rope is very different than injecting a child with medication for an adult. It's really foolish for you to try to conflate the two issues.

[JMHawkins]

So, I didn't really want to debate the specific merits of EpiPen laws, I merely wanted to use them as an example where the result of following the rules can be extremely negative.

 

I don't think SP is going to budge from his current position on epipens, so let's shift the debate slightly. Earlier this year, a man in England had a seizure and fell into a shallow pond. Onlookers quickly called for help, and police and fire fighters promptly showed up.

 

And did nothing.

 

They weren't allowed by their rules to go into the water to rescue the guy, that required special training, which they didn't have. So a man drowned in what amounted to a city park while several healthy adult males in police and firefighter uniforms walked around the edges of the pond poking sticks into the water to test it's depth because "the rules" said they couldn't go into over their ankles without special training and equipment.

 

Pretty much the same thing happened in California last year. Police and Firefighters stood around while a man drowned, saying they weren't authorized to go into the water. A woman, a civilian bystander, after watching these paid authorities do nothing, finally jumped in herself and tried to save the man, but it was too late. She retrieved his body for the big, strong, guys in their uniforms and badges.

 

Now, we can to a fro about Reach-Throw-Row-Go and how Go can be hazardous, and how a rescuer needs to avoid adding to the victim count, and disect these events in minute detail if we wish. Yet...

 

the spectacle of grown, healthy men in Police and Firefighter uniforms standing around refusing to help people in need because they were afraid of violating The Rules didn't go over well with the people who witnessed these events. Both juristiction have changed "the rules" since then, and given the exterme inertia of the modern civil service bureacracy, I don't believe any of the particpants have lost their jobs or been subjected to any sort of discipline. However...

 

Oak Tree's excellent list mentions R1. Obeying rules set by legitimate authorities is a moral imperative in itself. I agree, but the key phrase there is "legitmate authorities" and the actions of the authorities in the above two cases eroded their legitimacy. They were paralyzed by fear of their own obtuse rules.

 

All this is just a long way of saying that the only reason to have rules is to help produce better results, and you can't excuse bad results by saying you were following the rules. The means don't justify the ends.

 

Now, to specifically address SPs point about training, yes, absolutely, better training of the people at the scene is usually going to lead to better results because the people on hand will be better prepared to make good judgments. So the best approach a society, organization, nation, outfit, whatever, can take is to encourage people to acquire the skills necessary to have and use good judgement. Creating a detailed thicket of rules intended to manage the situation by remote control (remote in time and space) won't work. Rules that inhibit using judgement work contrary to the best interests of society, because they leave the members of that society unprepared to make appropriate decisions when it is vitally necessary for them to do so.

 

None of that is to say rules are bad. Bad rules are bad. Good rules are great. How do you tell them apart? Well, I think you have to use your judgement...

 

[Eagle92]

In regards to epipens, I think the point may be rather moot if the laws state give tot he level of training b/c epipens are now covered in basic first aid. At least in the AHA classes I can teach.

 

I'll give you another example of what rules.

 

As everyone knows CPR changed from Airways, Breathing, and Compressions (ABCs) to Compressions, Airways, Breathing (CABs). Also they now teach that if you do not have a barrier device, Mask, etc AND IT IS AN ADULT (emphasis as there are misconceptions out there), and you are uncomfortable doing mouth-to-mouth, then do compressions only. BUT IF IT IS AN INFANT OR CHILD YOU MUST DO THE BREATHING STILL (again MAJOR emphasis b/c that is the misconception: children don't need the breaths, when in reality it is most like a respiratory problem). So that is what is taught.

 

HOWEVER, the research that was done in making the CPR procedures shows that for drowning victims, it is actually better to do the old ABC method instead of the new CAB method. Rationale is that the drowned person does not have the oxygen content due to the drowning that a "normal" heart attack victim would have. This was written in the reports, and very, very breifly mentioned in the instructor recert class, but is not part of any training regime.

 

So what do you do if you encounter a drowning victim? Use what is in the research that you read and was briefly told works but is not part of the training , or do what you have been trained and ignore the research and the comment?

 

If you do the old procedure and something happens, wouldn't you be held liable for not following the proper procedures? And if you didn't do what the research says is a better method, but instead followed the proper procedures, wouldn't you still be held liable since you had knowledge of a better way fo doing something?

 

 

[Beavah]

If you do the old procedure and something happens, wouldn't you be held liable for not following the proper procedures? And if you didn't do what the research says is a better method, but instead followed the proper procedures, wouldn't you still be held liable since you had knowledge of a better way fo doing something?

 

Yah, let me say again that I don't think "bein' held liable" should ever be a consideration in living up to da Scout Oath. We help other people because it is right and proper to help other people. We jump in the water to save the drowning man because it is right to jump in and save the drowning man, despite the risk to ourselves. Da risk that perhaps a bit of our time or money might be taken up dealin' with a complaint pales in comparison to the risk of our life in the rescue, so why would yeh spend even a moment's thought on it?

 

Folks, the legal system is composed of ordinary good people, guided by ordinary good, decent, reasonably intelligent fellow citizens. It's not some swamp monster out there waitin' to eat you and your children. AHA studies show that many of our fellow citizens don't begin CPR or respond to folks in need because of their irrational fear of da legal system. THIS INANE NONSENSE ABOUT FEAR OF LIABILITY IS KILLING INNOCENT PEOPLE AND LEAVING CHILDREN WITHOUT THEIR PARENTS. IT IS EVERYWHERE AND ALWAYS DESPICABLE AND WRONG TO PERPETUATE THIS DESTRUCTIVE MYTH.

 

Yeh do what's right, and yeh trust others to also do what's right.

 

There's no way to offer real legal opinions across states, eh? But no, in no jurisdiction anywhere that I am aware of or can imagine, would anybody consider either of Eagle92s examples unreasonable breach of a duty of care for a civilian responder.

 

Beavah

 

[SeattlePioneer]

Hello JMHawkins,

 

 

 

[Beavah]

Throwing a drowning person a rope is very different than injecting a child with medication for an adult. It's really foolish for you to try to conflate the two issues.

 

In both cases, yeh are choosing to take lifesaving action.

 

In both cases, there is a small but non-zero risk that da action yeh take will cause death or some other undesirable outcome.

 

So in all of the things that matter, they are the same.

 

The only difference is da status of the "rules", and hence da real or perceived risk to yourself for engaging in the rescue. Whether yeh are willin' to risk yourself in attemptin' to save the life of another is of course your own decision to make. As is whether you're willin' to risk some degree of future inconvenience in attemptin' to save the life of another.

 

It is foolish to pass laws directing people not to intervene and to train employees not to act and then complain when they follow those directions.

 

Nah, I believe in personal accountability, eh?

 

The lawmaker is guilty of not thinkin' through all of da possibilities when writin' the law. That's an ordinary human error from not bein' omniscient.

 

The person who stood around and watched a fellow human bein' die rather than render aid is guilty of standing around and watching a fellow person die. They should properly be despised for their lack of courage and character.

 

Beavah

(This message has been edited by Beavah)

[johnponz]

Beav,

 

You are 100% correct (I would say 110% but that really is not possible-LOL). There is no excuse to stand by and let a fellow human being die if you can possibly help the person. No rule should supercede this one.

 

Everyone has to be able to live with their decsions so ultimately this is a personal decsion, but if my son is the human that is in this much trouble, I hope and pray the person helps.(This message has been edited by johnponz)

[SeattlePioneer]

>

 

 

 

In all Beavah's examples, the possibilities of bad outcomes is always "small" and the bad outcomes never happen.

 

Beavah's always does the right thing because he decides it's the right thing, no matter how bad the outcome may be.

 

No law or rule will constrain Beavah's unlimited self confidence.

 

 

As I said earlier, he is welcome to act as he pleases.

 

I think it's often foolishness myself.

 

Plenty of people die each year entering burning houses or drowning when they thing they are going to help someone. Often they are the only fatality in such situations.

 

Frankly, I don't think it's heroic. I think it's reckless and stupid.

 

But you and John Ponz feel free to dive on in.

 

 

 

 

[JMHawkins]

Good Morning SeattlePioneer (btw, what happened to our summer? seems to have taken an early bus out of town),

 

It is foolish to pass laws directing people not to intervene and to train employees not to act and then complain when they follow those directions.

 

If you want to complain, complain about those who are restricting their judgment about what to do.

 

I'm actually complaining about both. I'm not willing to cut the rulemakers as much slack as Beavah, I think they are guilty of more than ordinary human error. They sought out and accepted a position of responsibility and, through hubris, greed or stupidity have failed in ways that cause great harm to the rest of us, so I consider them at fault as well.

 

But I don't let the folks on the scene off either. "Just following orders" is famously not a defense for reprehensible conduct.

 

Thing is, both sets of people are part of the problem, which is a tendency to engage in impersonal, de-humanized, bureaucratic behavior. The hallmark of a bureaucracy is nobody is held accountable for outcomes, just for whether they followed the rules or not. That tends to bring out the worst in human behavior, 'cause if focuses people on themselves rather than what's going on around them. Those firefighters were asking "am I following the rules?" instead of "does that guy need help?"

 

I think this is an excellent area for us to discuss, because Scouting is an opportunity to address the issue with the rule-makers and rule-followers of the future, our Scouts. If we as representatives of adult authority in their world demonstrate bureaucratic thinking, we set the expectations with them that that's the way it should be. If instead we demonstrate personal responsibility, both as people who follow rules and who make and enforce them, we set that expectation.