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Prehospital emergency care in a humanitarian environment: an overview of the ethical considerations
  1. Tim Prescott1,2,
  2. S May3,
  3. S Horne4,5 and
  4. E Barnard4,6
  1. 1 Army Medical Service, Camberley, Surrey, UK
  2. 2 Department of Anaesthesia, Portsmouth Hospitals NHS Trust, Portsmouth, UK
  3. 3 Emergency Department, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  4. 4 Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  5. 5 Emergency Department, University Hospitals Plymouth NHS Trust, Plymouth, UK
  6. 6 Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Dr Tim Prescott, Army Medical Service, Camberley, Surrey, UK; timothywjprescott{at}


Recent history has demonstrated that UK Defence personnel can be used, potentially with little notice, in humanitarian disaster zones. The provision of prehospital emergency care (PHEC) in a humanitarian environment requires an innovative approach to overcome the technical challenges of a resource-limited setting. In addition to technical challenges, prehospital practitioners working in a humanitarian environment can expect to be faced with ethically testing situations that they are not familiar with in their usual practice. The organisational and individual ethical decision-making burden can result in significant harms. Therefore, the aim of this paper is to discuss the ethical considerations relevant to providing PHEC during a humanitarian disaster in order that personnel can be more prepared to optimally deliver care. This is a paper commissioned as a part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.

  • medical ethics
  • accident & emergency medicine
  • adult intensive & critical care
  • trauma management

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  • Contributors TP, SM, SH and EB contributed to the conception and content of the article. TP was responsible for the finalised drafting of the article with contributions from SM, SH and EB. Critical appraisal and approval of the article was provided by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.