Background

Patient participation should be understood in relation to vulnerability, power and responsibility. Patients in ambulance care have urgent care needs and are vulnerable in an asymmetrical relationship with the clinicians. This places great responsibility on the clinicians to use their power for the benefit of the patient. An invitation to participate requires an informed consent and depends on the patient’s willingness and ability to participate. Hence, as- sessment of the patient’s decision-making ability is central together with a caring approach to enhance trust and confidence. Undoubtedly, patient partici- pation is a challenge within contemporary ambu- lance care – where failure is likely to cause suffering.

Methods

Patient participation in ambulance care is discussed from philosophical, patient and person-centred perspectives in relation to empirical research of Bremer et al. (2012), Holmberg et al. (2014; 2015) and Rantala et al. (2015). 

Results

Patients are comfortable in their surrender to ambulance clinicians, obeying commands and being important while involved in the care. However, pa- tients are powerless when they experience ambulan- ce clinicians’ care as excessive, having a strong desire of being acknowledged in their suffering. This can be achieved by seeing the patient as capable and in- volve the patient and significant others in the deci- sion-making. In addition ambulance clinicians have an ambition to be pliable to the patient’s wishes, inviting the patient in a shared decision-making.

Conclusions

Patient participation in ambulance care can be understood as important for the patient’s wellbeing. However, unequal distribution of power within the ambulance clinician-patient relationship may challenge patient autonomy and interests. Is it pos- sible to achieve genuine patient participation in the context of ambulance care?