A video of a presentation by Dr Erin Smith during the Community Resilience Stream of the 2016 People in Disasters Conference. The presentation is titled, "A Qualitative Study of Paramedic Duty to Treat During Disaster Response".The abstract for this presentation reads as follows: Disasters place unprecedented demands on emergency medical services and test paramedic personal commitment to the health care profession. Despite this challenge, legal guidelines, professional codes of ethics and ambulance service management guidelines are largely silent on the issue of professional obligations during disasters. They provide little to no guidance on what is expected of paramedics or how they ought to approach their duty to treat in the face of risk. This research explores how paramedics view their duty to treat during disasters. Reasons that may limit or override such a duty are examined. Understanding these issues is important in enabling paramedics to make informed and defensible decisions during disasters. The authors employed qualitative methods to gather Australian paramedic perspectives. Participants' views were analysed and organised according to three emerging themes: the scope of individual paramedic obligations, the role and obligations of ambulance services, and the broader ethical context. Our findings suggest that paramedic decisions around duty to treat will largely depend on their individual perception of risk and competing obligations. A reciprocal obligation is expected of paramedic employers. Ambulance services need to provide their employees with the best current information about risks in order to assist paramedics in making defensible decisions in difficult circumstances. Education plays a key role in providing paramedics with an understanding and appreciation of fundamental professional obligations by focusing attention on both the medical and ethical challenges involved with disaster response. Finally, codes of ethics might be useful, but ultimately paramedic decisions around professional obligations will largely depend on their individual risk assessment, perception of risk, and personal value systems.
Whole document is available to authenticated members of The University of Auckland until Feb. 2014. The increasing scale of losses from earthquake disasters has reinforced the need for property owners to become proactive in seismic risk reduction programs. However, despite advancement in seismic design methods and legislative frameworks, building owners are often reluctant to adopt mitigation measures required to reduce earthquake losses. The magnitude of building collapses from the recent Christchurch earthquakes in New Zealand shows that owners of earthquake prone buildings (EPBs) are not adopting appropriate risk mitigation measures in their buildings. Owners of EPBs are found unwilling or lack motivation to adopt adequate mitigation measures that will reduce their vulnerability to seismic risks. This research investigates how to increase the likelihood of building owners undertaking appropriate mitigation actions that will reduce their vulnerability to earthquake disaster. A sequential two-phase mixed methods approach was adopted for the research investigation. Multiple case studies approach was adopted in the first qualitative phase, followed by the second quantitative research phase that includes the development and testing of a framework. The research findings reveal four categories of critical obstacles to building owners‘ decision to adopt earthquake loss prevention measures. These obstacles include perception, sociological, economic and institutional impediments. Intrinsic and extrinsic interventions are proposed as incentives for overcoming these barriers. The intrinsic motivators include using information communication networks such as mass media, policy entrepreneurs and community engagement in risk mitigation. Extrinsic motivators comprise the use of four groups of incentives namely; financial, regulatory, technological and property market incentives. These intrinsic and extrinsic interventions are essential for enhancing property owners‘ decisions to voluntarily adopt appropriate earthquake mitigation measures. The study concludes by providing specific recommendations that earthquake risk mitigation managers, city councils and stakeholders involved in risk mitigation in New Zealand and other seismic risk vulnerable countries could consider in earthquake risk management. Local authorities could adopt the framework developed in this study to demonstrate a combination of incentives and motivators that yield best-valued outcomes. Consequently, actions can be more specific and outcomes more effective. The implementation of these recommendations could offer greater reasons for the stakeholders and public to invest in building New Zealand‘s built environment resilience to earthquake disasters.
New Zealand has a long tradition of using light timber frame for construction of its domestic dwellings. After the most recent earthquakes (e.g. Canterbury earthquakes sequence), wooden residential houses showed satisfactory life safety performance. However, poor performance was reported in terms of their seismic resilience. Although numerous innovative methods to mitigate damage have been introduced to the New Zealand community in order to improve wooden house performance, these retrofit options have not been readily taken up. The low number of retrofitted wooden-framed houses leads to questions about whether homeowners are aware of the necessity of seismic retrofitting their houses to achieve a satisfactory seismic performance. This study aims to explore different retrofit technologies that can be applied to wooden-framed houses in Wellington, taking into account the need of homeowners to understand the risk, likelihood and extent of damage expected after an event. A survey will be conducted in Wellington about perceptions of homeowners towards the expected performance of their wooden-framed houses. The survey questions were designed to gain an understanding of homeowners' levels of safety and awareness of possible damage after a seismic event. Afterwards, a structural review of a sample of the houses will be undertaken to identify common features and detail potential seismic concerns. The findings will break down barriers to making improvements in the performance of wooden-framed houses and lead to enhancements in the confidence of homeowners in the event of future seismic activity. This will result in increased understanding and contribute towards an accessible knowledge base, which will possibly increase significantly the use of these technologies and avoid unnecessary economic and social costs after a seismic event.
The 2010–2011 Canterbury earthquakes, which involved widespread damage during the February 2011 event and ongoing aftershocks near the Christchurch Central Business District, left this community with more than $NZD 40 billion in losses (~20 % GDP), demolition of approximately 60 % of multi-storey concrete buildings (3 storeys and up), and closure of the core business district for over 2 years. The aftermath of the earthquake sequence has revealed unique issues and complexities for the owners of commercial and multi-storey residential buildings in relation to unexpected technical, legal, and financial challenges when making decisions regarding the future of their buildings impacted by the earthquakes. The paper presents a framework to understand the factors influencing post-earthquake decisions (repair or demolish) on multi-storey concrete buildings in Christchurch. The study, conducted in 2014, includes in-depth investigations on 15 case-study buildings using 27 semi-structured interviews with various property owners, property managers, insurers, engineers, and government authorities in New Zealand. The interviews revealed insights regarding the multitude of factors influencing post-earthquake decisions and losses. As expected, the level of damage and repairability (cost to repair) generally dictated the course of action. There is strong evidence, however, that other variables have significantly influenced the decision on a number of buildings, such as insurance, business strategies, perception of risks, building regulations (and compliance costs), and government decisions. The decision-making process for each building is complex and unique, not solely driven by structural damage. Furthermore, the findings have put the spotlight on insurance policy wordings and the paradoxical effect of insurance on the recovery of Christchurch, leading to other challenges and issues going forward.
