Thus, we have a conundrum. Public safety, especially law enforcement, requires employees to adhere to Kohlberg’s “Maintaining Social Order” stage (Stage 4) for much of their work. In fact, this reasoning is reinforced in law enforcement academies. In this stage of moral reasoning, adhering to the letter of the law trumps all other concerns. An example of this, of which I’m acutely aware, is a local Texas Highway Patrolman who wrote his wife a ticket for speeding. His moral reasoning was “she broke the law and the law must be enforced — no matter who the offender.”
Such a priority can conflict with the role of EMS. In our textbooks, and in education classes, we teach that the patient always comes first (after scene and personal safety). We emphasize that EMS personnel are advocates for the patient.Thus, in EMS education, we ask that EMTs and paramedics function, at a minimum, in Kohlberg’s “Social Contracts and Individual Rights” stage (Stage 5).
