Rules, shmules...

[SeattlePioneer]

Hello JMHawkins,

 

 

The problem is that having untrained people jump into a situation can just produce additional casualties or cause further injuries.

 

Just following your impulses to jump into a situation can often be foolish.

 

Here are a number of situations where jumping into an accident situation may not be the right thing to do:

 

 

Rescue and Transportation

 

If you are faced with the problem of rescuing a person threatened by fire, explosive or poisonous gases, or some other emergency, do not take action until you have had time to determine the extent of the danger and your ability to cope with it. In a large number of accidents the rescuer rushes in and becomes the second casualty. Do not take unnecessary chances! Do not attempt any rescue that needlessly endangers your own life!

 

 

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http://www.brooksidepress.org/Products/OperationalMedicine/DATA/operationalmed/Manuals/Standard1stAid/chapter11.html

 

[JMHawkins]

The problem is that having untrained people jump into a situation can just produce additional casualties or cause further injuries.

 

You're getting hung up on that point but I'm suggesting a larger issue.

 

Let's grant that both the bureaucratic and the personal responsibility world view want good outcomes - both would like to see people in need get help that doesn't cause additional harm and doesn't get other people hurt in the process. How do they go about that?

 

One world view encourages a group of experts to gather and debate things, eventually issuing a set of rules intended to produce good outcomes. Everyone else besides these experts are encouraged to defer to the experts and follow their rules even when the lay person seems to think those rules are likely to produce a bad outcome. Who are we to question the experts?

 

The other world view says it's unacceptable for people to stand around and let someone die when they might be able to help. The highest form of this world view holds that it is our personal responsiility to be prepared to render help. It encourages, expects, ordinary people to acquire a useful set of skills - including the ability to use good judgement - so that they have a chance of making a positive impact when in a position to do so. This second world view doesn't do away with rules, but it does change their nature. They are fewer in number and more general in scope. They set guidelines that are intended to help people make good choices instead of attempting to make those choices for them.

 

Acquiring a useful set of skills takes time and effort. It's unreasonable to expect the average person walking down the street to have the training (and equipment) of a trauma surgeon. However, human ingenuity is amazing. It creates things like EpiPens and AEDs that can be successfully used by people with no medical training. All they require is some good judgement and 99% of the time they will produce positive outcomes.

 

But even for things that require training, well, encourage it and encourage the time be devoted to learning usefull skills. Let's go back to the firefighters who wouldn't go in over their ankles to save a guy because they lacked the training officially required to do so. They had been trained on "the rules" that said they couldn't get their calves wet. They knew that. Their organization had prioritized training them on "the rules" over training them on "the skills" with the result being that when faced with a life-threatening emergency, they were able to quote the rules but unable to render assistance.

 

That's the sort of thing that happens in the first mindset. It creates the situation where the person on the spot lacks the training, iniative, mindset and courage to take the necessary action.

 

Think about Scouts out swimming.

 

Rule-based thinking: only a trained Lifeguard can Go into the water to rescue a drowning person. Untrained people should limit themselves to Reach, Throw and Row because experts have determined it is too dangerous for untrained persons to enter the water to attempt a rescue.

 

Results-based thinking: If someone is drowning, you need to be able to help them. Experts advise that rescuing a drowning person without putting yourself at risk requires skill, therefore you should learn Lifesaving so that you are prepared if the need arises.

 

Both cases encapsulate the exact same expert knowledge, but the first one encourages some nebulous responsibility for making sure the skills are present, while the second encourages personal responsibility for it. The motto of the first way is "not my job." The second is "be prepared."

 

 

[Eagle92]

JM,

 

One point of clarification. It is "Reach, Throw, Row, Go WITH SUPPORT ( emphasis).

 

None of the current lifeguarding programs that I know about, including BSA's, currently teaches how to make a rescue without support, i.e. rescue tube, buoy, etc.

 

 

[SeattlePioneer]

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I certainly have no objection to being prepared to act skillfully and responsibly. I do have an objection to untrained people jumping in to hazardous situations and doing harm or becoming additional casualties themselves.

 

Good intentions by themselves frequently aren't enough.

[Beavah]

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

 

As I mentioned, we've had a fairly recent fatality from someone throwing a rope to a scout who was struggling in water. The lad wrapped the rope around his hand, the scouter lost control of his end, and the rope snagged rocks in the river, draggin' the lad under. We killed a scout because someone tossed him a rescue line. In all likelihood the lad would have been OK had no rescue been attempted, or had folks opted for a boat rescue.

 

The point is that yeh have to make a judgment about when the possibility of a bad outcome from acting is smaller than the possibility of a bad outcome from not acting. That's da reasonable, rational judgment. Is da risk of leavin' the boy unaided in the water greater than the risk of throwin' him a line? It was, so the proper choice was to throw the rope, even though the outcome of that choice was adverse.

 

By and large, though, da most common "impulse" on the part of folks is not to act. That's why we hear calls from time to time for "mandatory" reporting laws and such, eh? Mostly, people don't act, even when da evidence is pretty clear. In many cases, people don't act even though they have been properly trained. What yeh worry about -just "jumping in" - is far more rare, and it happens in cases where acting is appropriate, but the folks don't have the skill, or their judgment is compromised by emotional stuff.

 

I hear yeh on that score. Nobody is sayin' always jump in; nobody is sayin' that they're always right, or that their choices will never lead to a bad outcome. Least of all me! My choices have led to bad outcomes on many an occasion.

 

What we're sayin' is that we are all personally responsible for our own choices. We should each be held accountable by God and our fellow men for our choices to act, or not to act. And therefore we must each inform ourselves, and use our best judgment. We should be prepared. We should learn how to use a throw rope, and if we're carryin' epinephrine or have a scout with allergies, we should learn how and when to use it properly. We should understand and be thoughtful about relative risks, and be comfortable with ambiguity that requires judgment.

 

Because no human "rule", no matter how wise, can ever anticipate all possible circumstances. And not all human rules are wise.

 

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.

 

Exactly.

 

Beavah

 

 

 

[SeattlePioneer]

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I interpret this as meaning that if you are trained to a suitable level of proficiency, you will be able to make reasonable judgments. I have no issue with that.

 

If you don't have training and experience, making judgments on the fly especially against expert advice you are aware of is unlikely to be a good idea.

[Beavah]

If you don't have training and experience, making judgments on the fly especially against expert advice you are aware of is unlikely to be a good idea.

 

Well, you're goin' to be faced with needin' to make a judgment regardless. As I tell every scouter and youth leader, not doin' something is as much of a choice as doin' something.

 

But yep, I agree with what I think yeh mean here. An inexperienced person should strongly consider expert advice and make an effort to understand it before they ever consider simply ignorin' it.

 

That's why folks here were lookin' for da risk assessment figures on wheelbarrows and carts, eh? Because da actual risks might not be intuitive, and we might discover that RichardB actually can show that so many scouts are injured by wheelbarrows each year that it merits a prohibition. That sort of expert input helps inform everyone's judgment, eh? Now not only do we understand da reason for the ban, but we also understand da mechanisms and conditions where it may be OK to make an exception.

 

Da problem with epinephrine is that it is largely on da controlled substances list because of da needles, and the risk of usin' the injectors for drug abuse. Until very recently, yeh could buy epinephrine inhalers over the counter which had da same concentration drug delivered more quickly; they were removed from da OTC market for environmental reasons, and I presume for da potential as a precursor in methamphetamine production. So when yeh understand that da reason for the "expert" rules has to do with a general desire to protect society from da risks of drug abuse, then yeh can also understand that makin' an exception for use in an emergent case where those risks don't apply is a reasonable thing.

 

Now, I think as Scouters, one of the things we should teach scouts is that it's not enough just to follow any rule blindly. Our duty as citizens and particularly when we're responsible for others is to inform ourselves, and understand da purpose and scope and intent of the rule. That's how we are prepared to exercise better judgment, and not make decisions either to act or not to act completely "on the fly."

 

Beavah

 

[skeptic]

http://online.wsj.com/article/SB10000872396390443989204577603341710975650.html?google_editors_picks=true

 

 

This was recommended to me by one of my former scouts who is now a Lt. Col in the Army. It sort of fits with the current back and forth here. Make sure you get the "whole" link, as often the highlighted ones leave some off for some reason.

 

Did find it interesting.