[DRAFT] Uniform Emergency Medical Care

[Corrich]

Hello everyone! I scrolled through past legislation and couldn't find a resolution (or proposal) for uniform EMS practices, which I thought is necessary, especially for underdeveloped countries. Here's my first attempt, and it's a little bit wordy I must admit. However, it does seem like a sound piece of legislation! Very open to criticism, it's my first time even posting on a forum here.

Title: Uniform Emergency Medical Service Regulations
Category: Health
Area of Effect: Healthcare

THE WORLD ASSEMBLY,

RECOGNIZING that nations independently implement standards for Emergency Medical Service and Emergency Medical Technician certification by region-specific training and qualifying examination,

REALIZING that the standard of care in patient emergency assessment and transport is vulnerable to questions of sterility and professionality in developing countries/countries facing economic instability,

UNDERSTANDING that bureaucratic crisis management and fund allocation for cardiac, respiratory, and trauma emergencies may fall short in developing countries/countries facing economic instability,

BELIEVING that while emergency medical care costs are variable in price, basic emergency medical care should be not only available, but efficient and effective,

DESIRING to implement universal emergency care standard as to facilitate international advancement in public health standards and reduction in mortality due to cardiac, respiratory, trauma, and other emergencies,

The World Assembly HEREBY,

DEFINES, for the purpose of this resolution

1. “Emergency Medical Service” as a facility which treats injury or illness requiring rapid medical response, providing out-of-hospital care and transport to long-term treatment.
2. “Emergency Medical Technician” as an entry-level clinician trained to respond swiftly to emergency situations regarding traumatic injury, accident scenes and general medical issues requiring immediate attention. Emergency Medical Technicians can administer CPR, glucose, and oxygen.
3. “Paramedic” as a technician trained to provide emergency medical care to seriously injured/ill individuals with the goal to stabilize the patient before long-term care is administered. Paramedics can perform complex procedures including the insertion of IV lines, provision of life-saving drugs, and application of pacemakers.
4. “Basic Life Support” is patient care conducted exclusively by EMTs, and is used to stabilize a patient without the use of drugs or invasive procedures.
5. “Advanced Life Support” is patient care conducted by a team of EMTs and paramedics, and is used to stabilize a patient by all means necessary, including but not limited to: injections, administration of medication, administration of an IV, cardiac monitoring.
6.“Medical Transport Service” as a vehicle equipped with adequate, sterile medical equipment for taking sick and injured patients to places for long-term patient care.
7. “Medical equipment” as basic support devices available on a medical emergency transport vehicle, including:
a. Ventilation and Airway equipment
b. Monitoring and Defibrillation equipment
c. Immobilization devices,
d. Bandages
e. Two-Way Communication Devices
f. Obstetrical Kit
g. Infection Control Tools
h. Injury-Prevention Equipment

MANDATES that member-states employ, at a minimum, a set of regulations that:

1. Adhere to the proposed definition of Basic Life Support, and implement legislation to promote BLS regulations in state-run and (if applicable) private Emergency Medical Service.
2. Adhere to the proposed standard of medical equipment, and implement legislation to promote medical supplies’ regulation in state-run and (if applicable) private Emergency Medical Service.
3. Adhere to the proposed standard of medical transport services, and implement legislation to promote medical transport services’ regulation in state-run and (if applicable) private Emergency Medical Service.

ESTABLISHES the Department of Medical Emergency Management (DMEM), a branch of the General Accounting Office (GAO), which will:

a. Grant funds, upon request, to any nation requesting aid to meet the requirements of the proposal.
b. Determine a sufficient amount of financial aid for the needful Member-State, while working to wean the nation off the support the office provides.
c. Determine if a nation is economically stable enough to cease distribution of Medical Emergency financial aid.
d. Receive earmarked donation by Member-States.

CLARIFIES

• That the aforementioned provisions are subject to extant legislation.
• That the resolution will not require nor encourage state-funded emergency medical service, as the resolution only mandates regulation of the emergency medical practice.
• That the resolution will not regulate Advanced Life Support personnel or transport, as the resolution proposed does not apply to paramedics.
• That the DMEM will receive funding from earmarked donation only, and will not require Member-States to provide direct funding in exchange for grant approval.
• That nothing in the resolution prevents Member-States from applying for aid for Emergency Medical Management, however, Member-States in a period of economic development and disadvantage are likely to be prioritized.
• That nothing in the resolution prevents Member-States from including unlisted healthcare-related tools in BLS ambulances, but the equipment included is required.

[Grays Harbor]

Why would we need a one-size-fits-all EMT program?

[Corrich]

Why would we need a one-size-fits-all EMT program?

Although I do see how it can be perceived as an all-encompassing EMT system, I'd define it more as assurance that ill and injured patients of a nation are able to be treated effectively and efficiently. Take the safe syringe motion at vote for example: it's not something to be perceived as "forced upon" all Member-States, but a regulatory measure proposed to keep people safe. This proposal works similarly, except it's not an unfunded mandate.

[Araraukar]

I'd define it more as assurance that ill and injured patients of a nation are able to be treated effectively

OOC: That's already done by the combination of two existing resolutions. (Though obviously the effectiveness is within realistic expectations; if there's no 100% cure for an illness, it can't be expected either.)

[Bears Armed]

OOC
Some of the specifications might not be appropriate for some nations with non-human populations.

[Verdant Haven]

You write well, and it looks like a lot of effort went in to this. As a concept though, I’m definitely confused what is actually being accomplished. Nothing is mandated beyond some definitions of words, and the creation of a committee to give financial aid to nations that nations that have trouble agreeing to a definition. Here are the specifics of my thoughts:

Definitions:

You define 7 terms. Two of those terms (Paramedic and Advanced Life Support) are never used again, except to say that this bill doesn’t apply to them. Those definitions should be removed, as they are utterly irrelevant. Replace the clarification about them with something along the lines of “nothing in this bill limits the establishment or operation of more advanced forms of emergency medical care.”

You define an Emergency Medical Service as a “facility,” but what you describe is an ambulance service. You separately define Medical Transport Service as a specific vehicle. The former definition, amended to remove “facility,” would be the definition to keep with either of these two terms, and I’d suggest changing the second term to Ambulance, which is what it is describing.

You define Medical Equipment with very specific categories, some of which may or may not be relevant to a given population. An obstetrical kit, for example, is unnecessary in those nations with vat-grown populations. I would probably add something to the effect of “if relevant to the population served” and make note that this definition of equipment should serve as a minimum, without restriction on the addition of further equipment to a nation’s BLS mandated equipment list. The present format of the bill demands that this, and only this, be the definition used.

Your definition of Emergency Medical Technician speaks of administering glucose and oxygen – a human-centric concept. While that is considered acceptable from a legality perspective in the WA, it tends to provoke a certain number of “no” votes from nations and delegates with non-human populations.

I already suggested getting rid of the definition of Paramedic, but if you don’t… what do you mean by application of pacemakers? Are you talking about an AED? That’s a function sufficiently basic you don’t even need an EMT to do it (I’m trained to do that IRL, and I’ve got nothing to do with the medical field), and defibrillation equipment is specified as a BLS item in the medical equipment category. Am I unfamiliar with a different definition of pacemaker, which has nothing to do with the surgically implanted pacemakers that are the most common use of that word?

For those definitions for which you go on to use acronyms (EMT and BLS for example), you should include the acronym with the definition: Emergency Medical Technician” (EMT)…

Mandates:

All three mandates do the following:
1) Require the use of the provided definition
2) Require a regulation to implement legislation to promote regulation
3) Nothing further

The operative clause should change from employing a set of regulations that do these things, to simply doing these things.

I would very strongly encourage that this mandate actually doing something beyond “promoting” regulations. Legislation to “promote” regulation doesn’t actually do a thing, so the entire bill is reduced to cheerleading.

I would also suggest changing the words “proposed definition” and “proposed standard” to “provided definition” and “provided standard” – should the bill come to a vote and pass, it is no longer a proposal, so the mandate would lose even what thin meaning it currently has.

If you want this mandate to actually do something, it has to do more than define terms and promote regulation – it needs to actually put those terms to use. As is, you could say “Sure, we define ‘Emergency Medical Technician’ as what the bill says, but we don’t have any of those. We have ‘First Responders’ and they’re not bound by any of this.” I think you’re going to run in to a lot of resistance to this kind of demand, given that EMS is not a one size fits all issue on real-world Earth, much less in NationStates, but without actually doing something I daresay this bill would get struck down as illegal for not actually having an operative clause. Forming a committee can’t be the proposal’s only action.

The Committee:

With a mandate that only requires nations to use a definition and promote unspecified regulations, there is no financial burden. As such, there is no purpose to financial aid. Nations literally don’t have to do anything, so this is basically a committee without a cause.

Clarifications:

The first clarification (extant legislation) is a requirement of all WA laws, so is not necessary. There aren’t any other options.

The second clarification (regulation only) is inaccurate, as this bill does not mandate regulation. It mandates promotion of regulation, which is the same as saying it does nothing at all.

The third clarification is covered in the first item I mentioned under “Definitions”

The fourth clarification may be partly unnecessary. The WA cannot require member states to provide funding, period, so it probably isn't necessary to say it in those terms.

The fifth clarification uses the term Emergency Medical Management, but this is never defined.

The sixth clarification touches on what I suggested above, but is still a bit strict. The definition needs to be allowed to be changed, ie, the member nation needs to be able to internally mandate additional equipment, not just “include” additional items. What is presently the “definition” needs to be more of a “definition includes, at minimum, and if relevant to the population served”

[Teretstein]

No. Our citizens are required to have either private healthcare or healthcare provided by their employer. The standards are far better than this.

[Kenmoria]

No. Our citizens are required to have either private healthcare or healthcare provided by their employer. The standards are far better than this.

(OOC: If the standards are better then your standards won’t change. This will only have an effect if the standards in your nation are worse than those required by legislation. In principle, I believe that this proposal could be a good addition to GA law, though after a drafting period.)

[Corrich]

You write well, and it looks like a lot of effort went in to this. As a concept though, I’m definitely confused what is actually being accomplished. Nothing is mandated beyond some definitions of words, and the creation of a committee to give financial aid to nations that nations that have trouble agreeing to a definition. Here are the specifics of my thoughts:

Definitions:

You define 7 terms. Two of those terms (Paramedic and Advanced Life Support) are never used again, except to say that this bill doesn’t apply to them. Those definitions should be removed, as they are utterly irrelevant. Replace the clarification about them with something along the lines of “nothing in this bill limits the establishment or operation of more advanced forms of emergency medical care.”

You define an Emergency Medical Service as a “facility,” but what you describe is an ambulance service. You separately define Medical Transport Service as a specific vehicle. The former definition, amended to remove “facility,” would be the definition to keep with either of these two terms, and I’d suggest changing the second term to Ambulance, which is what it is describing.

You define Medical Equipment with very specific categories, some of which may or may not be relevant to a given population. An obstetrical kit, for example, is unnecessary in those nations with vat-grown populations. I would probably add something to the effect of “if relevant to the population served” and make note that this definition of equipment should serve as a minimum, without restriction on the addition of further equipment to a nation’s BLS mandated equipment list. The present format of the bill demands that this, and only this, be the definition used.

Your definition of Emergency Medical Technician speaks of administering glucose and oxygen – a human-centric concept. While that is considered acceptable from a legality perspective in the WA, it tends to provoke a certain number of “no” votes from nations and delegates with non-human populations.

I already suggested getting rid of the definition of Paramedic, but if you don’t… what do you mean by application of pacemakers? Are you talking about an AED? That’s a function sufficiently basic you don’t even need an EMT to do it (I’m trained to do that IRL, and I’ve got nothing to do with the medical field), and defibrillation equipment is specified as a BLS item in the medical equipment category. Am I unfamiliar with a different definition of pacemaker, which has nothing to do with the surgically implanted pacemakers that are the most common use of that word?

For those definitions for which you go on to use acronyms (EMT and BLS for example), you should include the acronym with the definition: Emergency Medical Technician” (EMT)…

Mandates:

All three mandates do the following:
1) Require the use of the provided definition
2) Require a regulation to implement legislation to promote regulation
3) Nothing further

The operative clause should change from employing a set of regulations that do these things, to simply doing these things.

I would very strongly encourage that this mandate actually doing something beyond “promoting” regulations. Legislation to “promote” regulation doesn’t actually do a thing, so the entire bill is reduced to cheerleading.

I would also suggest changing the words “proposed definition” and “proposed standard” to “provided definition” and “provided standard” – should the bill come to a vote and pass, it is no longer a proposal, so the mandate would lose even what thin meaning it currently has.

If you want this mandate to actually do something, it has to do more than define terms and promote regulation – it needs to actually put those terms to use. As is, you could say “Sure, we define ‘Emergency Medical Technician’ as what the bill says, but we don’t have any of those. We have ‘First Responders’ and they’re not bound by any of this.” I think you’re going to run in to a lot of resistance to this kind of demand, given that EMS is not a one size fits all issue on real-world Earth, much less in NationStates, but without actually doing something I daresay this bill would get struck down as illegal for not actually having an operative clause. Forming a committee can’t be the proposal’s only action.

The Committee:

With a mandate that only requires nations to use a definition and promote unspecified regulations, there is no financial burden. As such, there is no purpose to financial aid. Nations literally don’t have to do anything, so this is basically a committee without a cause.

Clarifications:

The first clarification (extant legislation) is a requirement of all WA laws, so is not necessary. There aren’t any other options.

The second clarification (regulation only) is inaccurate, as this bill does not mandate regulation. It mandates promotion of regulation, which is the same as saying it does nothing at all.

The third clarification is covered in the first item I mentioned under “Definitions”

The fourth clarification may be partly unnecessary. The WA cannot require member states to provide funding, period, so it probably isn't necessary to say it in those terms.

The fifth clarification uses the term Emergency Medical Management, but this is never defined.

The sixth clarification touches on what I suggested above, but is still a bit strict. The definition needs to be allowed to be changed, ie, the member nation needs to be able to internally mandate additional equipment, not just “include” additional items. What is presently the “definition” needs to be more of a “definition includes, at minimum, and if relevant to the population served”

Thanks for taking the time to review. Another draft will be up soon which will clarify the purpose/strengthen the legitimacy of the legislation.

No. Our citizens are required to have either private healthcare or healthcare provided by their employer. The standards are far better than this.

(OOC: If the standards are better then your standards won’t change. This will only have an effect if the standards in your nation are worse than those required by legislation. In principle, I believe that this proposal could be a good addition to GA law, though after a drafting period.)

Thanks. I'll be putting a good deal of work into it before it's proposed.

[Imperium Anglorum]

The Patients' Rights Act (check spelling) requires that everyone already get emergency medical care.

[Araraukar]

The Patients' Rights Act (check spelling) requires that everyone already get emergency medical care.

OOC: They don't listen...