Should EMS/Fire be armed?

[EpiEMS]

@DrParasite, I'm enjoying this discussion a lot & definitely appreciate your points. I want to focus on one or two where I think I can add value:

My confusion is (and this is entirely ignorance on my part) is why some people who carry 24/7 when off duty, have issues carrying while on the ambulance. Yes, I understand training, liability, etc, but does those change whether you are in your POV or if you are in an ambulance? All the fear-mongering (lawsuits, media, criminal investigation) doesn't change, depending on if you are duty or not, so while those are valid concerns, they apply in all situations, not just ones when on the ambulance.

And since you mentioned optics/PR, what would optics/PR be for an EMS agency that had its crew hospitalized by an attacker? or ambushed by a bad guy? or if you were that EMS manager, what would you tell the wife of a paramedic who was the victim of an armed robbery, who was shot by a bad guy for his narcs? What would the optics be on that one? Or does the PR say that the public will accept a few dead and injured EMS providers, in exchange for feeling safer? BTW, I know PR is part of your MBA program, so I am asking for your expert advice on this topic.

I wouldn't say I'm a PR expert, but when I think of it from the communications side of things, the simplest message is "we were victimized despite all of our efforts to protect our people." From a liability standpoint, you likely already have training & policies to reasonably mitigate risk, (hopefully) satisfying your duty to the employee. We see much less blame placed on EMS providers who are the victims of aggression. than we would on an EMS provider who uses lethal force in self defense...and your agency might have to defend itself, too.

All of the lawsuits, media, and criminal investigation could change drastically if you are on-duty versus off-duty - your agency could be at risk and you might be held to a different standard personally. See, for example (emphasis mine):

Generally, applicable standards of care regarding the management of difficult or violent patients don’t include the use of firearms to threaten or subdue a patient, or the use of deadly force by EMS providers. In other words, an EMS provider, and therefore the EMS agency, could very well be found to be negligent when personal injury or death results from the use of a firearm carried by an EMS provider on duty. That liability could arise when that harm or those injuries are suffered by a patient, a bystander or anyone else injured by the provider’s firearm–regardless of who ended up firing it.

Doug Wolfberg

From a system design perspective, I am not sure what the answer to this question is:

Does two lives saved justify it, especially if it costs no innocent lives? That's the same reason I support the cops keeping their weapons... even if they never fire their weapon, if it saves a cop's life, doesn't that make it worth it?

I will say we need to be attentive to what we don't know, especially in the absence of evidence or research (e.g., cost effectiveness analysis). I don't disagree with your conclusion, though.

 

[DrParasite]

We see much less blame placed on EMS providers who are the victims of aggression. than we would on an EMS provider who uses lethal force in self defense...and your agency might have to defend itself, too.

Blame? so someone is actually blaming EMS providers for being the victims of an assault? Did they deserve it? Were they asking for it? Do you really want to go down the rabbit hole of blaming the victim? because I could go further, and it would result in the thread getting locked and likely me getting put in time out by @ffemt8978, and I'd rather that not happen.

the optics wouldn't look good anytime someone (EMS provider or otherwise) uses lethal force in self defense, but how do the optics look when an EMS provider is assaulted and suffers a career-ending injury? or is confined to a wheel chair? or suffers brain damage from having their head smashed into the diamond plate of the ambulance by an EDP? Is that considered acceptable to you, or any other provider? I mean, how did the optics look in Australia, where two drunk women weren't even sent to jail after they ended the career of a 40 year veteran paramedic? I'm not saying they should have been shot in self defense, but are we accepting that getting attacked is part of the job that has little to no consequences for the attacker? And don't get me started on what happened to FDNY EMT Yadira Arroyo... And they now have signs in the ambulance that say assaulting a paramedic is a felony, and FDNY launched a PR campaign to Reminds Public it’s Not O.K. to Assault EMTs, Paramedics...

All of the lawsuits, media, and criminal investigation could change drastically if you are on-duty versus off-duty - your agency could be at risk and you might be held to a different standard personally. See, for example (emphasis mine):

Generally, applicable standards of care regarding the management of difficult or violent patients don’t include the use of firearms to threaten or subdue a patient, or the use of deadly force by EMS providers. In other words, an EMS provider, and therefore the EMS agency, could very well be found to be negligent when personal injury or death results from the use of a firearm carried by an EMS provider on duty. That liability could arise when that harm or those injuries are suffered by a patient, a bystander or anyone else injured by the provider’s firearm–regardless of who ended up firing it.

Doug Wolfberg

I like PWW (although I think Steve is more entertaining), and I think they are 100% right... they are legal experts. But they didn't answer the other side of the question: Could an agency be found negligent if a provider is injured, and the agency forbids them from carrying, despite the provider having a CCW? The agency failed to protect their provider, and as a result, that is why the provider was injured or killed? Or are we (the lawyers) more worried about someone else suing the agency, because we all know that we (EMS agencies) don't pay our employees enough for them to hire a good attorney in case we do something wrong that results in them getting hurt on the job?

I'll take it one step further: while the theoretical liability is great, can anyone provide a court case of an EMS provider or agency being held liable by a judge or jury due to a shooting by their paramedics? It's been allowed for 3+ years in several states, and I know people that carry, even if it's against the rules.

Here is another legal question: many years ago, my partner was assaulted by an EDP. Should she have sued our employer for not protecting her? And the prosecutor refused to charge the attacker with anything, even though the entire thing was witnessed by PD (the officer was standing next to her when the assault happened). Do we (as line staff) need to start suing our employers when something happens, so they have a financial incentive to allow us to protect ourselves?

I completely agree that "applicable standards of care regarding the management of difficult or violent patients don’t include the use of firearms"; however, where do the applicable standards fall when an EMS provider is forced to defend themselves against a lethal threat?

There is a lot of legal "theory," which is very valid, and that's why lawyers get paid a lot. But a lot of these theories are just that, theoretical, at least until a court actually finds against you, establishing case law.

 

[EpiEMS]

Blame? so someone is actually blaming EMS providers for being the victims of an assault?

Yes, I think there is a percentage of the public that says "you made a knowing choice of a profession". Doesn't make it right.
The point of my comment was mainly that there is an optical element here - your PIO has an easier job in the victim case than in the self-defense case, and there's many fewer questions that will be asked.

the optics wouldn't look good anytime someone (EMS provider or otherwise) uses lethal force in self defense, but how do the optics look when an EMS provider is assaulted

Agreed on your first point. I think the optics of EMS providers being assaulted are not that poor, unfortunately -- something like 70% of EMS providers have been physically assaulted, which is an unfortunate reality that is very amenable to policy changes.

but are we accepting that getting attacked is part of the job that has little to no consequences for the attacker?

It does seem like that is the (sad) policy consensus these days, but I am not convinced that the public is amenable to CCWs as the solution, nor am I convinced that agencies would be best served by allowing CCWs, mainly from the liability perspective, but also the weapon retention perspective.

Could an agency be found negligent if a provider is injured, and the agency forbids them from carrying, despite the provider having a CCW? The agency failed to protect their provider, and as a result, that is why the provider was injured or killed?

A bit out of my scope, but seems like the CCW point is hard to prove. That said, you do have some duty of care owed to you by your employer -- that's pretty general OSHA expectations, but not sure what extent that applies to emergency services.

I'll take it one step further: while the theoretical liability is great, can anyone provide a court case of an EMS provider or agency being held liable by a judge or jury due to a shooting by their paramedics? It's been allowed for 3+ years in several states, and I know people that carry, even if it's against the rules.

Haven't seen anything & didn't see anything on Lexis Nexis, but I'm not a legal researcher by any means. If folks are carrying against employer policy, they are at risk of being terminated, based on what PWW had to say.

 

[johnrsemt]

As sad as it is: Maybe EMS providers are going to have to start suing their companies and maybe even the local PD for not protecting them. Take it a step further and sue the patient/EDP for attacking them.

When I worked retail before and during my 1st 2 years in EMS the longest prison term someone got for being found guilty of committing assault and battery on me while I was at work was 50 years. Since I have been in EMS the longest jail time someone has gotten for being found guilty of committing assault and battery on me was 19 hours for 'time served': the time he waited for his girlfriend to bring $250 bail money to the county jail. That attack cost me 2 broken ribs; when he found out that I wasn't taking him to the hospital he wanted to go to, 2 states away. Yes I got to work with 2 EMT-B's until I could lift the cot with a patient on it again, because we were short medics, but I wasn't reimbursed for lost income for my PT job.

 

[johnrsemt]

Maybe if everyone in EMS and Fire and the Police start suing their attackers for committing assault and battery, and sexual assault maybe the attacks will drop off.

 

[ffemt8978]

Maybe if everyone in EMS and Fire and the Police start suing their attackers for committing assault and battery, and sexual assault maybe the attacks will drop off.

In today's politically charged environment, would that really be a smart idea?

 

[Jim37F]

Somehow I doubt people that assault EMS providers are doing so after a calculated and thoughtful consideration of the pros and cons and cost/benefits analysis, where others being sued will actually impact and influence their behaviors.

 

[Peak]

Somehow I doubt people that assault EMS providers are doing so after a calculated and thoughtful consideration of the pros and cons and cost/benefits analysis, where others being sued will actually impact and influence their behaviors.

Or actually be able to pay any of the judgement.

 

[ffemt8978]

Or actually be able to pay any of the judgement.

Or their medical bills

 

[Carlos Danger]

I don’t believe that most EMS providers would be able to meet the training and qualification standards required to safely retain and use a firearm.

I believe arming EMS workers is a huge liability issue that EMS agencies should not have to assume. A provider carrying an unauthorized weapon while on duty could prove catastrophic to an agency if that weapon were ever displayed or discharged.

Anecdotal experience, I have been in violent situations that have ended without the use of firearms. Had I or my partner been armed, that might not have been the case.

My personal opinion... as a quality improvement and education manager, based on the poor judgement and lack of control I’ve witnessed, I am very scared about putting weapons in the hands of many of the providers on the street.

I am not anti-gun. However, I don’t believe prehospital providers need to carry a firearm while on duty and since this has been circulating through the EMS world, I’ve yet to hear a compelling argument that will convince me to change my mind.

I think those are very reasonable concerns and I largely share them, which is one of the reasons why I never have and probably never will advocate for "armed EMS", in terms of EMS agencies having their field personnel carry weapons as a routine part of their duties. I think that's probably neither necessary or wise.

However, I also think that an individual's ability to possess and utilize the means to defend themselves against violent aggression is the most fundamental of all rights, and as often as we "Mericans are chided as being "gun crazy", I actually don't think we show enough respect for that right.

With the mindset of self-defense as a fundamental right, it follows that an individual who is properly trained (and we can certainly debate what that means, but lets do it in the Gun Thread, because it is a totally different discussion than this) and credentialed to carry a firearm in public cannot justly be denied the right to do so just because they put on their work uniform or enter a church or a hospital. How does it make any sense that my right to carry a concealed pistol all day long as I run errands and shop and eat out is legally recognized and mostly respected, but the recognition of that right magically disappears when I show up to work at the hospital (where we're all sitting ducks for a deranged mass shooter) or on the ambulance, where we routinely enter situations that likely present a much higher risk than usual for violence? I'm every bit the responsible citizen when I'm at work that I am when I'm not at work, and my rights are the same.

The concerns with citizens possessing guns are completely overblown and based entirely on emotion rather than reason. Just look at the stats over the past few decades. Since the early 90's the number of privately owned guns and concealed carry permits has steadily increased, while rates of gun crimes have steadily decreased. Yes, we've seen a surge in gun crime the past year or two, but the incidence of gun violence is still way below where it was throughout most of our history leading up to when it started a long steady decline in the late 80's / early 90's, which is even more impressive when you consider that rates of gun ownership have skyrocketed in the past handful of years. Simply put, guns and concealed carrying are both statistically safer than ever. And while it is easy to imagine scenarios where a citizen - whether at work to not - who is carrying overreacts or poorly reacts in a situation and makes that situation much worse, examples of that happening are actually really hard to come by. It turns out that even though the training requirements to carry concealed in most states are way less than what many people (including myself) think they should be, concealed carriers actually seem to use pretty good judgment.

Bottom line, I do not support "armed EMS". But I do strongly support responsible, trained individuals being allowed to carry concealed at work, even on the ambulance.

 

[DrParasite]

Wow, I think this is one of the rare times when @Carlos Danger and I are in complete agreement on a topic.

And I think there are two different interpretations of "armed EMS", which is causing some confusion.

One group considers armed EMS to mean "here is your stethoscope, here is your glock", which most people (myself included) think is a bad idea.

The other groups considered armed EMS to me "people who are lawful firearm owners, carry when off duty, but are banned from carrying when on duty." That is the question that I still haven't heard a good answer to (other than the theoretical liability for the agency, but I haven't seen any case law supporting that theory, nor has anyone explored the liability an agency faces when employees sue them for not preventing assaults by bad guys)

Also, much of the opposition appears to be based on emotion, feelings, and fear of what might happen. are there any statistics that can validate if the fears are justified or completely baseless?

 

[FiremanMike]

Wow, I think this is one of the rare times when @Carlos Danger and I are in complete agreement on a topic.

And I think there are two different interpretations of "armed EMS", which is causing some confusion.

One group considers armed EMS to mean "here is your stethoscope, here is your glock", which most people (myself included) think is a bad idea.

The other groups considered armed EMS to me "people who are lawful firearm owners, carry when off duty, but are banned from carrying when on duty." That is the question that I still haven't heard a good answer to (other than the theoretical liability for the agency, but I haven't seen any case law supporting that theory, nor has anyone explored the liability an agency faces when employees sue them for not preventing assaults by bad guys)

Also, much of the opposition appears to be based on emotion, feelings, and fear of what might happen. are there any statistics that can validate if the fears are justified or completely baseless?

Counterpoint - just as you say those against armed EMS are arguing emotion, I feel the same could be said for those in favor of armed EMS.. "Bad things happen on runs, I feel like it'd be safer if I had a gun".

Truth is - armed EMS is such a rarity that I don't think there are statistics available to validate either side of this discussion..

 

[GMCmedic]

Counterpoint - just as you say those against armed EMS are arguing emotion, I feel the same could be said for those in favor of armed EMS.. "Bad things happen on runs, I feel like it'd be safer if I had a gun".

Truth is - armed EMS is such a rarity that I don't think there are statistics available to validate either side of this discussion..

Anytime something even slightly becomes political, emotions rule.

Like it or not, the politics can't be ignored. We are of course discussing arming a group of responders just a few short months after enduring protests over armed responders.

 

[EpiEMS]

I'm every bit the responsible citizen when I'm at work that I am when I'm not at work, and my rights are the same.

Respectfully disagree -- my understanding is that (particularly for non-government employees) rights at work are definitely not the same at work vs. not at work. For example, you don't have the right to free speech at work, nor do you enjoy the same protections against search and seizure in your workplace that you might otherwise have. With respect to firearms, employees really don't have many rights at work (with a few limited exceptions, like in some states where you can store your gun in your car).

Bottom line, I do not support "armed EMS". But I do strongly support responsible, trained individuals being allowed to carry concealed at work, even on the ambulance.

I'm not in disagreement, in principle, but from the agency management POV, I can totally understand why they would be opposed. Now, if we're talking about sworn LEOs, different story - even a conservative (from a risk perspective) manager might be a bit more willing there.

Simply put, guns and concealed carrying are both statistically safer than ever

100% agreed, and so is the country, so even less of a need to potentially use* a firearm
*Taken broadly to include brandishing as a deterrent, even

The other groups considered armed EMS to me "people who are lawful firearm owners, carry when off duty, but are banned from carrying when on duty." That is the question that I still haven't heard a good answer to (other than the theoretical liability for the agency, but I haven't seen any case law supporting that theory, nor has anyone explored the liability an agency faces when employees sue them for not preventing assaults by bad guys)

I don't know if there is case law around it, but would be very interested to hear from an attorney. Liability for preventing an assault is also a good question, my admittedly limited understanding is that if the employer is taking reasonable affirmative steps to mitigate the risk, then that goes a pretty fair way to protecting them...

I haven't seen any academic research on armed EMS, and in the absence of evidence, I am wary of really changing things up.

 

[Carlos Danger]

Respectfully disagree -- my understanding is that (particularly for non-government employees) rights at work are definitely not the same at work vs. not at work. For example, you don't have the right to free speech at work, nor do you enjoy the same protections against search and seizure in your workplace that you might otherwise have. With respect to firearms, employees really don't have many rights at work (with a few limited exceptions, like in some states where you can store your gun in your car).

There's no question that employers can legally place all kinds of restrictions on the behaviors of their employees, and that employees essentially consent to those rules by voluntarily keeping that employment. But just because something is legal doesn't mean it is just. Your innate right to protect yourself from violent aggression doesn't disappear just because your employer decides they'd rather you not bring your gun to work.

100% agreed, and so is the country, so even less of a need to potentially use* a firearm
*Taken broadly to include brandishing as a deterrent, even

Most people will never have a fire in their house, but it is still considered common sense to have a fire extinguisher. Most people will never be in a serious car crash, but wearing a seat belt while driving is a no-brainer. Similarly. that the vast majority of people will never need to use a gun for self defense isn't a very good argument against having one.

 

[EpiEMS]

There's no question that employers can legally place all kinds of restrictions on the behaviors of their employees, and that employees essentially consent to those rules by voluntarily keeping that employment. But just because something is legal doesn't mean it is just. Your innate right to protect yourself from violent aggression doesn't disappear just because your employer decides they'd rather you not bring your gun to work.

Totally agreed with your point. But just or unjust, I think you'd be hard pressed to find an employer willing to let a licensed CCW person carry on their property except in a limited suite of roles (e.g., armed security).

Most people will never have a fire in their house, but it is still considered common sense to have a fire extinguisher. Most people will never be in a serious car crash, but wearing a seat belt while driving is a no-brainer. Similarly. that the vast majority of people will never need to use a gun for self defense isn't a very good argument against having one.

I'm far from anti-firearms ownership, but the risk from having fire safety equipment is pretty much one sided risk (pure upside -- you pay for it and then can only "win"), firearms reduce some risks & increase others, so it's not exactly the same.

 

[Kevin L]

I worked in EMS for 12 years, and that was 20 years ago.

I worked in some really nasty, f----ed up areas under awful circumstances.

The only reason why I could imagine a paramedic carrying a gun would be for dangerous animals. I work in South Florida, so we have alligators and crocodiles . . . as well as water moccasins, eastern diamondback rattlesnakes, canebrake rattlers, an epidemic of rabid raccoons, inbred (and psychotic) pit bulls reared for dog fighting, wild pigs (which can be dangerous), and so forth.

The closest I ever came to carrying a weapon was a cheap Italian stiletto-type switchblade . . . against the rules of my organization, but I was discreet.

Florida has a lot of canals and waterways, and passengers could become stuck upside-down in a car that's rolled over into a canal . . . and with the free-flowing alcohol around hollidays, it happened more often than you would think.

I wanted a knife that would open quickly with one hand and a minimum of manual dexterity, especially with cold, wet hands that are stuffed in medical gloves.

I--on one occasion--had to hold a man's head above water when we was upside-down in a rolled-over car. I cut his seatbelt and the tail of his shirt (which was caught up in the wrecked metal) with my switchblade.

There are specialty seatbelt cutters available, and so forth . . . but a switchblade always worked very well.

 

[DrParasite]

Most people will never be in a serious car crash, but wearing a seat belt while driving is a no-brainer.

Not true: As of 10 years ago, by auto insurance estimates "you will file a claim for a collision about once every 17.9 years. That's if you're an average driver, which, whether you're willing to admit it or not, you likely are. & Over the course of a typical long, driving lifetime, you should have a total of three to four accidents."

not only that

I haven't seen any academic research on armed EMS, and in the absence of evidence, I am wary of really changing things up.

So what you are saying is... we don't have much research on armed EMS providers (which isn't common in the US), and because we don't have any research, we shouldn't arm EMS providers, because there isn't any research on what happens, which is why are you wary about arming EMS providers (and for full disclosure, I mean allowed credentialed CCW people to carry on duty, not giving everyone a gun)... do I have that right?

 

[EpiEMS]

So what you are saying is... we don't have much research on armed EMS providers (which isn't common in the US), and because we don't have any research, we shouldn't arm EMS providers, because there isn't any research on what happens, which is why are you wary about arming EMS providers (and for full disclosure, I mean allowed credentialed CCW people to carry on duty, not giving everyone a gun)... do I have that right?

Sounded better in my head than on paper.

In short, we don't have a good sense for what the adverse outcomes could be and it is not reasonably certain that we'll get much upside. Thus, out of caution, I would be wary of permitting EMS providers who are on duty and legally enabled to carry a firearm as a credentialed CCW holder*, correct. There's just too much downside - the upside is there, sure, but I'm not convinced that it is a reason to stray from the status quo.

*That is, whatever the case may be that they are allowed to carry by law but are not current or former sworn LEOs or tactical medical personnel.

 

[CarSevenFour]

I've gone 'round and 'round about this issue in my mind while serving in the bad part of town. Actually, when I was younger, fresh out of college and on an ambulance to help pay tuition, I was totally liberal and anti-gun. Until I "needed" one on duty. I won't detail exactly what changed my mind, no one would believe it anyway, but finally came to the realization that having changed and become totally pro-gun, carrying one on duty was fraught with negatives. We dealt with deranged individuals cycling through the State of California and L.A. County mental health systems, and they posed the greatest risk to life and limb for my partner and me, but I could not bring myself to use a weapon against an individual who essentially showed up for a fistfight. I learned self-defense hand-to-hand techniques instead and always prevailed. The only PT that ever planted an effective impact on me was a left hook to the jaw while we were lowering the Model-30 gurney. It's pretty difficult to protect yourself while occupied with a handful of stretcher. I certainly didn't need a gun for that, just a simple question, "Why did you do that?!" That cut through his dementia and he settled down quickly. Over those years I learned how to shoot and enjoyed the shooting sports with my gun toting brothers, and it became a hobby with target shooting out in Lytle Creek, collecting pistols, light gunsmithing, and refurbishing old Curio and Replica class military arms to target shoot on Memorial Day and Veteran's Day. This comes down to a highly personal decision, to carry on duty or rely on luck and fast-talking skills to simmer a situation down to a low boil. I believe that, if I had a partner who chose to carry, I would have no problem with it if he or she was of sound mind and up to the task. It finally became a matter of deciding that, because we went into areas like courthouses, jails, mental health facilities, and "gun-free" zones, the firearm would be a liability.