firefighting ethics: principlism for burning issues

Firefighting Ethics:Principlism for Burning Issues

Per SandinRoyal Institute of Technology KTH

Stockholm, Sweden

ETHICAL PERSPECTIVES 16, no. 2(2009): 225-251.© 2009 by European Centre for Ethics, K.U.Leuven. All rights reserved. doi: 10.2143/EP.16.2.2041653

ABSTRACT. The ethics of firefighting is a seriously underexplored field. This is unfortunate, since firefighting raises issues of great social importance and has the potential to inform moral theorizing. In the first part of this paper, I explore possible reasons why firefighting ethics has received so little academic attention and argue that it warrants study in its own right. I do so primarily by comparing firefighting ethics to medical ethics, demonstrating their close relationship yet pointing out important differences: firefighting is less professionalized than medicine, the caregiver-patient relationship is not central in firefighting, fire-fighters need to concern themselves with other values than life and limb, they face greater and qualitatively different risks than medical personnel, and they have to make almost every operative decision under conditions of temporal stress. In the second part of the paper, I argue that some elements from medi-cal ethics may be adapted for use in firefighting ethics. I illustrate this by apply-ing four mid-level principles from mainstream medical ethics to firefighting – the principles of autonomy, non-maleficence, beneficence, and justice. I argue that they are indeed applicable in firefighting ethics, but that they need modifi-cation and their relative weight is different. Respect for autonomy is of limited importance in firefighting. Non-maleficence is important, and beneficence is central. The special principle of beneficence for firefighters is best thought of as grounded in firefighters’ contractual obligations rather than in a general prin-ciple that one should help someone in peril. As regards the principle of justice, there is a case for applying a utilitarian principle of justice on the operative level and a principle of a decent minimum aid on the policy level. The latter can be brought about by comparatively simple and low-cost means, such as a volunteer fire service and subsidized fire equipment.

KEYWORDS. Firefighting, principlism, triage

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ETHICAL PERSPECTIVES – JUNE 2009

I. INTRODUCTION

There is no such thing as an ethics of firefighting. Of course, firefighters do act morally and reflect upon moral questions related to their work. There are occasional codes of ethics for firefighters, but unlike the ethics of medicine, engineering, accountancy or law, for example, the ethics of firefighting has not been subject to academic study.

I think this is unfortunate for at least two reasons. First, firefighting is about safeguarding things of great societal and moral importance: peo-ple’s lives and well-being, of course, but also property and the environ-ment. For this reason, firefighters are expected to expose themselves to substantial risks, and considerable amounts of public money are spent on fire and rescue services. This calls for ethical reflection.

Secondly, firefighting might have something to tell us something about moral theory. Situations very much like those that firefighters and other members of fire and rescue services face are stock examples in moral philosophizing. Among the numerous philosophers who have used thought experiments involving rescue situations are William Godwin (2001, 81f.), Elisabeth Anscombe (cit. in Glover, 1990, 207f.), Peter Singer (1972), John Taurek (1977), Derek Parfit (1987), and Frances Kamm (2007). Our moral intuitions supposedly reflected in our reactions to these examples are meant to tell us something important about moral theory, and given the prominence of this ‘casuistry of emergencies’, to use David Wiggins’ phrase (1987, 88), there would appear to be much more reason, one would imagine, to study the real thing.

In the first part of this paper, I will explore possible reasons why the ethics of firefighting has received so little academic attention. I will argue that the ethics of firefighting warrants study in its own right and I will do so primarily by comparing firefighting ethics to medical ethics, demon-strating their close relationship yet pointing out important differences. In the second part of the paper, I will take the fact that medical ethics and firefighting ethics are closely related but nevertheless different as a start-


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SANDIN – FIREFIGHTING ETHICS

ing point. I will argue that some elements from medical ethics may be adapted for use in firefighting ethics. I will demonstrate this by applying four principles from mainstream medical ethics to firefighting ethics – the principles of autonomy, non-maleficence, beneficence, and justice. I will argue that they are indeed applicable in firefighting ethics, but that they need modification and their relative weight is different.

II. WHY IS THERE NO ETHICS OF FIREFIGHTING?

There may be several reasons why the ethics of firefighting has been the subject of little academic attention. One possible reason is that there is no need for a firefighting ethics. The ethical issues relevant to firefighting, it could be argued, have been thoroughly discussed in other areas, and we only need to transfer those results to firefighting.

Perhaps police ethics or military ethics are suitable starting points. There are indeed some striking similarities. Police, firefighters and soldiers all wear uniforms and insignia, they work in hierarchical organisations, the members of which are predominantly male, and there is a shared terminology of ‘sergeants’, ‘lieutenants’, ‘squads’, and ‘battalions’. The metaphor of firefighting is also very powerful. The military as well as police and firefighters are expected to perform difficult tasks requiring quick decisions under difficult, sometimes extreme conditions. Firefighters and police often work together, for instance at the site of an accident, although they perform different tasks. At a typical traffic accident the police direct traffic, uphold order and investigate the causes of the accident, while firefighters extinguish fires and free crash victims from their vehicles.

There are also shared historical roots. In the nineteenth century, for example, firefighters were sometimes employed by insurance companies, but others were in fact members of the police force. Police brigades and insurance brigades sometimes coexisted (Ewen 2006). The emphasis on discipline and obedience is also a case in point. The fire service was often




arranged in a strictly hierarchical manner. Many firemen were ex-sailors, and discipline “was the driving force behind the management of fire bri-gades” (ibid., 58).

Although these themes are well worth exploring, I will not pursue them here for two reasons. First, considerations of space. Second, and more importantly, there are some notable differences between the prac-tices from an ethics point of view. The main cluster of questions in police ethics as well as military ethics concerns the legitimate use of violence.1 This, however, is not an issue in firefighting.

It would seem natural, therefore, to turn to medical ethics, in par-ticular the ethics of emergency medicine, as there are obvious parallels.

III. FIREFIGHTING ETHICS AND MEDICAL ETHICS

Triage

Both firefighting and medicine sometimes require quick decisions under stress, and triage, that is the sorting of casualties and the efficient alloca-tion of scarce resources, is relevant in firefighting as well as in emergency medicine.2

Firefighters, however, will not make triage decisions solely on the basis of a patient’s medical condition, but to a large extent on the basis of other considerations. Firefighters, for example, also make triage deci-sions regarding buildings and property. I will return to this below.

A short example should illustrate the point here. Firefighters are entering a seriously overcrowded building where hundreds of teenagers have been having a party. A fire has broken out. The building is filling with smoke, there is widespread panic, and some victims have lost conscious-ness. It is dark. The escape routes are completely inadequate and literally blocked with panic-stricken teenagers, and the only way to get anyone out in time is by lifting them through the windows, which are located about




six feet above floor level. The firefighters decide to lift girls out first. The reason is that girls are typically smaller and lighter than boys, and by giv-ing priority to girls more lives can be saved before the firefighters are exhausted. This is a triage decision, but the criteria are not medical.

Technological development

Another similarity between medical ethics and firefighting ethics is that both doctors and firefighters have vastly improved their ability to achieve their aims in the last two hundred years, and if more can be done there will be new ethical questions to ponder. If you can transplant organs from a dead person to someone else, for instance, the question arises whether you should do so. From a practical point of view, this question was not relevant before the development of transplant surgery.

The period since 1850 has seen a tremendous increase in medicine’s ability to diagnose and treat illness and injuries. Among the examples are X-rays, antibiotics, parenteral nutrition, assisted ventilation, and antide-pressants. In roughly the same period, firefighting has seen the introduc-tion of steam pumpers, ladder vehicles, hydraulic platforms, self-contained breathing apparatuses, Nomex clothing, and thermal vision systems (Green-Hughes 1979). Of course, technological development is very much ongoing in both fields.

In addition, and beginning somewhat earlier, both areas have wit-nessed advances in the preventative field: sanitation and vaccines in med-icine; stone cities, firewalls and broader streets in firefighting. There seems to be a slight difference here, however. In medicine, advances in science came first. In the late 1800’s, doctors became able to scientifically classify and diagnose illnesses, while remaining unable to treat them (Porter 1997, 685f.). Medical technology developed later. In firefighting, technological advances seem to have preceded scientific ones.

Despite these similarities, however, there are also several differences between firefighting ethics and medical ethics.




Degree of professionalization

It should be noted in the first instance that ‘medical ethics’ has been understood for a considerable period of time to be more or less synony-mous with ‘the professional ethics of physicians’. The medical profession is very old indeed, and has had an equally long tradition of professional ethics since Hippocrates.

Medicine is a profession, but not all types of occupation are profes-sions. Several criteria have been proposed for distinguishing the profes-sions from other types of occupation. Among them are the presence of a systematic theory and a requirement of advanced formal training. The following quote from Caroline Whitbeck is representative:

Professions are those occupations that both require advanced study and mastery of a specialized body of knowledge and undertake to pro-mote, ensure, or safeguard some matter that significantly affects others’ well-being (Whitbeck 1998, 74).

At least until recently, firefighting has not been a professional undertaking in this sense, and the degree of professionalisation continues to be nota-bly less than in medicine (although it must be emphasised that this is a matter of degree.) A great deal of firefighting, especially in non-urban areas, is carried out by part-time personnel and volunteers, and formal training for firefighters is typically shorter and less theoretical than that of doctors. This means that firefighting ethics has much less of a profes-sional tradition to lean on than medical ethics. There is no widely known ancient oath for firefighters to quote and relate to.

Caregivers and patients

A second difference between firefighting and medical ethics is that the centrality of the particular caregiver-patient relationship in medical ethics is lacking in firefighting ethics. Of course, something similar might occur




in life-saving situations. One could argue that the relationship between a firefighter and a person he is attempting to save from dying in a smoke-filled room is, or at least should be, conceived of in the same way as the relationship between a doctor and her patient, whose life she is trying to save. Firefighters’ relationships with their ‘patients’, however, are usually more transient than a typical doctor-patient relationship. Furthermore, firefighters and other rescue workers often meet casualties before the emergency medical personnel arrive on the scene. Admittedly, paramedics might also be in this situation, but the literature on the ethics of paramed-ics and ambulance services is remarkably limited.3

Plurality of values

A third difference between firefighting and medicine, related to the sec-ond, is that while medical personnel care for their patients’ life, limb, and well-being, firefighters also care for property, the environment and other valuable items not directly related to the well-being of individuals. Their business is not only about saving lives, but also about reducing economic loss and loss of other values, such as the aesthetic value of a forest. Presumably, life takes precedence over limb and limb over property. Thus the decision to attempt to save someone’s life in one building while leaving another, uninhabited building to burn down is uncontroversial, but firefighters also have to consider what property should be given priority over other property. Consider the following example:

There is a fire in a warehouse. It is out of control and the warehouse is doomed. The firefighters therefore have to direct their efforts at saving nearby buildings. There are only two such buildings, A and B, and the firefighters can save either one of them, but not both. What criteria should be used to decide which building should be saved, assuming that there are no relevant side-effects, such that a fire in building A is likely to spread further while a fire in building B is not, and so on?




Levels of risk

A fourth difference is that the levels of risk involved in firefighting are typically greater than the risks that doctors face. It is true that doctors and other medical personnel are exposed to risks that are not inconsider-able, among them such matters as contamination, for example, or vio-lence from patients and their relatives. Doctors, however, do not usually have to consider whether to attempt to save someone at great risk to themselves. Firefighters continually have to face an immediate risk of death and serious injury.

It might be argued that this merely shows that not all parts of medi-cal ethics involve the problems that firefighters have to deal with, but at least in emergency medicine, it could be claimed, the problems and demands are similar. Some commentators argue, for example, that emer-gency medicine is an activity that requires the virtue of courage, which firefighting surely requires. An illustration can be found in an article by James Adams (et al 1996). They define courage as “fortitude to do what is required, what is right, in the face of unpleasant or aversive conditions” (963). As examples of such conditions, they mention violent patients, communicable disease, unpleasant demeanour and malodour. These examples are far from convincing. First, medical personnel can often use effective and comparatively simple precautions against contamination, and require assistance from the police to handle violent patients, which means that opportunities for displaying courage are comparatively rare. Secondly, it is questionable whether the conditions Adams et al refer to really require courage. To claim that it would be courageous to treat a par-ticularly smelly or ugly patient would be plainly ridiculous. If that were the case, every hospital orderly or home help would be displaying courage on a daily basis. Important as such occupations are, this would be a strange conception of courage.

It might be that the difference between medical ethics and firefight-ing ethics in this respect is a matter of degree. While I agree that both




emergency medicine personnel and firefighters are exposed to risks and perform tasks that require courage, the difference in degree remains sig-nificant nevertheless.

The fact that firefighters are exposed to great risks of immediate death or injury and that they also have to consider other values than life or well-being of individuals leads to some weighing problems that doctors typically do not face.

First, there is the issue of firefighters’ weighing risks to themselves against risks to others. It happens that firefighters expose themselves to great risks in order to improve the chances of saving others. I will return to this problem.

Secondly, there is the problem of firefighters’ weighing risk to them-selves against risks to other values than human life or well-being. While it is true that firefighters are typically not expected to risk their own life in attempting to save a building, the said risks cannot be reduced to zero and may at times be considerable. If any risk to the life or limb of fire-fighters attempting to save an empty building were unacceptable, then no such firefighting would be possible. The question will thus be to deter-mine either a level of risk that is acceptable or one that is negligible.

Lack of time

A fifth and final difference is that firefighters in operative situations are always short of time, and it is rarerly possible to consult with colleagues, the patient herself or her relatives, let alone an ethics committee. In med-ical ethics, however, the same urgency is not always a consideration. Take the example of informed consent. There is widespread agreement that participants in clinical research should give informed consent to any research procedures. This might not be possible in emergency or trauma care, since the patients might be unconscious, confused, or require imme-diate anaesthesia. According to a recent study, however, even in this type of care, 77% of patients were able to give consent – personally or by




proxy – within 30 minutes of arrival at the trauma centre (Sava et al 2007). Nevertheless, this is still a different time scale than firefighters often find themselves working under in operative situations. This means that fire-fighting ethics will have to be concerned with advance planning, for instance drafting codes of ethics and training firefighters to deal with ethical questions. This is particularly important, since the lack of oppor-tunity for consultation in operative situations will require that very diffi-cult decisions will have to be made by individual firefighters. Again, it must be emphasised that the difference between firefighting ethics and medical ethics in this respect is a matter of degree.

To summarise: There are many similarities between firefighting ethics and medical ethics, but there are also important differences: First, firefighting is less professionalized than medicine. Second, the caregiver-patient relationship is not as central in firefighting as in medicine. Third, firefighters need to concern themselves with other values than life and limb to a greater extent than medical personnel do. Fourth, firefighters face greater risks to them-selves (and different types of risk) than medical personnel do. Fifth, firefight-ers have to make almost every operative decision under conditions of tem-poral stress, with limited possibilities for consultation with colleagues.

In the next section, I will draw upon the fact that medical ethics and firefighting ethics are closely related but nevertheless different. I will do so by attempting to apply four principles from mainstream bioethics to firefighting ethics. I will argue that the principles are applicable, but that their content and relative weight should be conceived of differently in firefighting ethics.

IV. PRINCIPLISM IN FIREFIGHTING ETHICS

One widely used textbook in medical ethics – Beauchamp and Childress’ Principles of Biomedical Ethics – is centered around what the authors call ‘the




four-principles approach to biomedical ethics’ or ‘principlism’ (Beau-champ and Childress 2001, 23). The principles in question are respect for autonomy, non-maleficence, beneficence, and justice.

These principles are ‘mid-level’ principles. This means that they are not about ultimate justification for moral judgements. Instead, they are compatible with a number of different fundamental ethical theories, such as Kantian deontology or one or other form of consequentialism. The rationale behind the idea of mid-level principles has been summarized by Kuczewski as follows:

Theories are too general to provide guidance for action but many the-ories converge on the mid-level principles and some specific rules for action (Kuczewski 1998, 516).

While Beauchamp and Childress’ views are not shared by everyone, the principles they discuss nevertheless represent the mainstream in medical ethics, and the principles themselves have been applied to other areas as well, such as business ethics (Fisher 2001).

Bearing this in mind, I will take this set of principles as a starting point for a discussion of what firefighting ethics might contain. ‘Principle’ must be understood in a very wide sense here, just as in Beauchamp and Chil-dress’ discussion. Of course, I do not claim to cover every aspect of these principles with regard to firefighting. I will only be able to sketch a rough outline of a principlist approach to firefighting ethics. It should also be added that I do not think that principlism is the only possible approach to firefighting ethics – one could also envisage a discussion of firefighters’ role-responsibilities or virtues – but I will not pursue that here.

Before embarking on the principlist project, we should note that fire-fighters do a lot more than extinguish fires and rescue people. They par-take in preventative work, pump out flooded cellars and drive heavy vehicles. They wash the fire engines and maintain their equipment. They exercise, and often injure themselves while doing so. Naturally, the exact




tasks of firefighters vary between different ranks, forces, and countries – fighting bushfires in Australia is very different from fighting a fire on a ferry in Scandinavia, to mention but two extremes. In what follows, however, I will focus primarily on tasks that are particular to firefighting and perhaps rescue services more generally, that is, typical fire and rescue situations. I will also limit the discussion to the situation in peacetime and in the developed part of the world, with a focus on structural firefighting rather than wildland firefighting.4 With a few exceptions, the discussion is limited to operative issues. Only towards the end will I say something about questions of firefighting policy.

Let us now turn to the principles themselves.

Respect for autonomy

The first principle is respect for autonomy. In medical ethics, this principle has often been discussed in the context of patients’ choices: their freedom to refuse treatment, their right to informed consent, physicians’ obligation to disclose information regarding a patient’s condition, the patient’s right to privacy, and so on. These situations are not very common for firefight-ers, and consequently, respect for autonomy is not a principle that one would expect to be highly relevant in firefighting ethics.

Nevertheless, firefighters may encounter situations in which they are likely to interfere with someone’s autonomy while carrying out their task. Consider the following example:

Firefighters are evacuating a village threatened by a raging forest fire. An elderly woman refuses to leave her house, saying that she wants to die there. She has no relatives, and she is capable of adequate decision-mak-ing. Leaving legal considerations aside, should she be evacuated against her will?

This case is parallel to refusal of treatment in medical ethics. Fire-fighters, by contrast, will typically face the problem in emergencies. Time is short, and there is little time to determine whether the plea not to be




rescued reflects a stable wish or not. Thus, in the presumably rare cases in which firefighters interfere with people’s autonomy, their actions can arguably be justified with reference to emergency exceptions. There will indeed be some problematic cases, for instance when a competent deci-sion-maker deliberately sets fire to herself in order to commit suicide, without putting anyone else at risk. But such cases are presumably rare.

Non-maleficence

The second principle is non-maleficence, which “asserts an obligation not to inflict harm on others” (Beuchamp and Childress 2001, 113). Unlike the principle of respect for autonomy, this principle is very clearly relevant for firefighting ethics.

There are many situations in which firefighters carry out activities that might be harmful. For instance – and I will focus on harms construed as harm to people rather than to goods – grinders or hydraulic cutters used for extricating victims in car crashes and similar situations are dangerous pieces of machinery, as are chain saws and other tools. Furthermore, someone might fall from a ladder, or a fire engine might run someone over or crash into another vehicle. What is noteworthy here in contrast to medical ethics, is the fact that the harms are likely to befall not only the ‘patients’, but third parties and firefighters themselves. Thus, a principle of non-maleficence needs specification in this respect.

In the context of the principle of non-maleficence, Beauchamp and Childress critically discuss a number of distinctions that have been prominent in medical ethics. Some of them are applicable in firefighting ethics as well, and I will discuss one of them here that seems relevant for firefighting, namely the distinction between withdrawing and withholding treatment.

In medicine, some people think it generally worse to withdraw treatment than to withhold treatment. The firefighting parallel to the distinction between withholding and withdrawing treatment would be




abstaining from initiation of a rescue or firefighting effort and the abortion of such an effort. Let us consider the following example by way of illustration. It draws upon a situation that occurred during the rescue operation after the bombing of the Alfred P. Murrah Federal Building, Oklahoma City, in 1995 (as described in Lewis, Tenzer and Harrison 1999).

Firefighters arrive at a building where there has been an explosion, possibly caused by a terrorist attack, and begin rescue work. Several hundred people are wounded. Some time into the operation, something that might be a second explosive device is spotted. The firefighters are ordered to withdraw from the building. However, there are many firefighters on the scene, and they are in different situations: Team 1 arrived at the scene early, and have been working for some time. They are in the process of carrying out a victim on a stretcher. Team 2 arrived later at the scene, and have just begun attempts to release a victim trapped under debris. They know that this operation will take time. Team 3, a reinforcement team, just arrived and are ready to enter the building. Suppose that when the order to immediately evacuate arrives, the three teams obey without delay. Team 1 then, arguably, withdraws aid to the victim while Team 3 withholds aid. It is not clear whether Team 2 withholds or withdraws aid.

The distinction, resting on the distinction between actions and omissions, is as unclear in firefighting as it is in medicine. Furthermore, if we think that withholding aid is justifiable while withdrawing is not, this has counterintuitive consequences. Suppose that Team 3 can go in and save someone very quickly, and be out again before Team 1 has been able to carry their victim to safety – should Team 3 not proceed?

I think the distinction between withholding and withdrawing aid should be dropped. This does not mean that we are at a loss about how to solve the practical problem. Should everyone evacuate and abandon the victims or not? One possible response to the problem is to use a criterion of timeliness. This is what the fire chief in fact did in the Oklahoma City case (Lewis, Tenzer and Harrison 1999, 627). Those firefighters who will be able to save someone quickly should do so, while rescues that are likely to take time




should not proceed. Thus, a rescue might well be initiated if it is quick, and one might be aborted if it is expected to be prolonged. This criterion does not hinge upon the distinction between withholding and withdrawing aid. Instead, it can be grounded in the level of risk. Staying in the building with the suspected explosive device means that firefighters knowingly expose themselves to great risks. The longer they stay, presumably, the greater the risk. As Lewis, Tenzer, and Harrison note, “[s]tandard emergency response procedures emphasize the safety of responders as the first concern” (626). But safety is not an absolute concept. As we noted earlier, the risks to firefighters can never be removed completely. Of course, no activity can be completely risk free – not even staying in bed – but, arguably, when all reasonable measures to reduce risk have been taken, the residual risk for firefighters will nevertheless be considerable and higher than for most other occupations. Furthermore, the victims are also exposed to the risk posed by the explosive device. Thus, it might be argued that with reference to a reasonable (for firefighters) level of risk, quick rescues might be carried out, but not prolonged ones. Team 1 should carry out their victim quickly, Team 2 should abort their rescue, and Team 3 will have to determine whether they can manage a quick rescue.

Beneficence

The third principle is beneficence. Beneficence is usually construed as more demanding than (mere) non-maleficence. In addition to not causing harm, beneficence requires actual contribution to the welfare of others. The distinction is not sharp, but it is widespread and intuitively appealing, and I will therefore accept it here.

According to Beauchamp and Childress “[p]romoting the welfare of patients – not merely avoiding harm – expresses medicine’s goal, ratio-nale, and justification” (2001, 172). This is “the implicit assumption of beneficence that exists in medical and health care professions and their institutional contexts” (ibid.).




It seems uncontroversial to assume that this is true for firefighting as well. In one code of ethics for firefighters, it is stated: “We acknowledge that our three fundamental duties are to serve this community; to safe-guard lives and property; and to respect the rights of all” (Prince George’s County, Maryland Fire/EMS Department 2008). The duty to serve and safeguard is an instance of the principle of beneficence, described by Beauchamp and Childress as “a moral obligation to act for the benefit of others” (2001, 166, italics original). However, there is an important amendment to the principle of beneficence here, namely the duty to safe-guard property (and other valuable things) in addition to life and limb.

Even if the principle of beneficence is uncontroversial in firefighting ethics, one may still ask what its foundations are. There are at least two possibilities: either (a) the special principle of beneficence for firefighters is derived from the general principle of helping someone in peril, or (b) it is derived from contractual obligations of firefighters.5

Let us first turn to the general principle of helping someone in peril. There is a widespread idea that there is an obligation to act beneficently and help someone in an emergency, given that it can be done without excessive risk to the helper. Even an extreme individualist like Ayn Rand accepts that we should help other people in emergencies – but in her case, only in emergencies (Rand 1963).

In Beauchamp and Childress’ version of this principle, person X has an obligation of beneficence towards another person Y if and only if (i) Y is facing a major risk of harm, (ii) X’s action is necessary to prevent the harm from befalling Y, (iii) X’s preventive action is likely to be successful, (iv) there is no significant risk or burden to X, and (v) the expected benefits to Y outweigh other adverse effects that X’s action is expected to cause.

A typical example is where I pass a burning house. The stairs are on fire. A trapped man is leaning out of a window on the third floor, scream-ing for help. There is a long ladder lying nearby that I can erect without much effort, which will allow the man to escape to safety. Conditions (i) to (v) are fulfilled, and I thus have an obligation to help the man. (Note




that we are dealing with what can be reasonably expected here, not the actual consequences of my action. It might be that my action somehow has consequences that turn out to be disastrous, so that they outweigh the good done – the man I save might be a murderous lunatic who kills me and a number of bystanders – but I cannot reasonably expect that.)

It could be argued that firefighters’ duty to safeguard and benefit others is derived from the fact that they typically find themselves in situ-ations like the one in the example: The victims of a fire face a major risk of harm, the firefighters efforts are necessary and are likely to be effective, and the good done can be expected to outweigh the harm. However, firefighting, as we saw earlier, often violates condition (iv). In other words, it cannot be carried out without significant risks to the firefighters. Fur-thermore, the individual rescue case is rather different from the work professional firefighters do.

To illustrate this, I will turn to an argument used in a recent article on how occupational health risks in a more general sense can be justified (Persson 2008). In the said article, the author asks: “Why is it commonly accepted that firemen [sic] have to take severe risks that most of us would find unacceptable in other situations?” (ibid., 164). In addition to profes-sional firefighters – Case (A) – Persson introduces three other examples for comparison:

Case (B): Professional founders, who are exposed to a significant risk of burns in their business of making statues.Case (C): An amateur founder of statues, who in her spare time faces risks similar to those of the professional founders.Case (D): A person who happens to pass a house on fire where a child is in distress. She saves the child, and supposedly the risks she under-takes are “similar to the risks professional firemen [sic] on duty occa-sionally undertake”.

With regard to Case (D), Persson claims that “we find it natural that she did what she did, and we might even find it to be her duty to take that risk” (ibid.). In line with this claim, Persson concludes that “most people




would agree that the two life-saving situations [i.e. (A) and (D)] justify a much higher degree of risk-taking than the two others.” But, according to Persson, there is no obvious difference between the occupational situ-ations (A) and (B) and the non-occupational ones:

[T]his example indicates that the reasons that may exist for acceptance of certain higher work-related risks have no intimate connection to one’s occupation. Rather, certain risks seem to be more acceptable because they are intimately connected with certain activities and the benefits gained from them (Persson 2008, p. 165. Italics original).

I will limit my focus to the differences between Cases (A) and (D). There are at least two potentially relevant differences between these cases that Persson does not mention.

First, the passer-by’s rescue of the child is a very unusual event, guar-anteed to make the headlines. It is an act of a type for which people are awarded medals of heroism.6 Many of us never find ourselves in such situations, let alone one in which we have a reasonable chance of being successful, something that Persson presupposes in his example. Firefight-ers, on the other hand, are routinely exposed to such risks. They face them regularly.

Secondly, the risks that firefighters face are better known to them than to the non-professional, once-in-a-lifetime, passer-by rescuer. The passer-by is probably not aware of the potential hazards of rescuing someone from a burning house. Firefighters, on the other hand, can be expected to be aware of the hazards and they have adequate equipment. They pre-sumably know how fires typically develop in different types of building, and so on. The firefighters are thus more in a situation of risk than one of uncertainty. (A decision made under risk is a decision where the prob-abilities of outcomes are known. A decision made under uncertainty is a decision made without known probabilities. I assume the difference to be a matter of degree here.) Obviously, this is not to say that individual firefighters can or should perform a quantitative risk assessment (QRA)




before entering a building on fire. Nevertheless, more can be said with reasonable confidence about the level of risk to firefighters than about the risks to one-time rescuers. On a policy level QRAs are quite appropri-ate. Suppose, for instance, that the management of a fire department is discussing whether to reduce the number of firefighters in the primary turnout team from nine to seven, due to budget constraints. Here, QRA and related methods can certainly be useful (cf. Beauchamp and Childress 2001, 194-214). In the context of individual rescues, however, there seems to be no place for QRA.

The comparison is thus between a passer-by facing an uncommon and unknown one-time risk, and firefighters facing a comparatively well-known risk regularly, in the course of their ordinary work. The cases are by no means parallel. Thus, it seems that a special principle of beneficence for firefighters cannot be derived directly from a general principle of assisting people in emergencies. It is therefore more plausible to locate it in the con-tractual obligations of firefighters. While in an earlier age, firefighters were often contracted by insurance companies, today they are typically employed by cities and funded by public money. Bearing this in mind, a commitment cited above that “our three fundamental duties are to serve this community; to safeguard lives and property; and to respect the rights of all” (Prince George’s County, Maryland, Fire/EMS Department 2008. Italics mine), seems highly plausible. In addition, firefighters enter the service voluntarily – it is a popu-lar job – knowing that there are risks involved, and they arguably receive reasonably fair compensation for their work. This is not to say that their wages, pensions and other benefits should not be better, but merely that firefighters are not generally taken to be among the blatantly exploited.

Justice

The fourth principle, justice, is probably the one about which most can be said. ‘Justice’ has a number of meanings, and the term is often cited among the essentially contested concepts. All agree that justice




is a good thing, but there is no agreement about its substantial con-tent.

Here I will be concerned merely with distributive justice, or more narrowly, the fair distribution of benefits and burdens. What I will pres-ent, it must again be emphasised, is thus only an example of what a principle of justice might prescribe in a firefighting context.

Having said this, the principle of justice can be invoked in firefighting on at least two different levels: The operative level – this is the level with which we have hitherto been concerned – and the policy level. On the operative level, the question concerns what justice requires of firefighters and their chiefs when they carry out their tasks, and I have focussed on rescue situations. Questions on this level relate to the professional ethics (or perhaps occupational ethics) of firefighters. On the policy level, how-ever, the questions concern what a just policy of firefighting might be. Such questions might include how many fire engines a city should have, for example, or where the fire stations should be located, and so on. This divi-sion of levels is quite similar to the one in medical ethics between a doc-tor’s operative decisions – for instance regarding whom to treat first in the emergency ward – and policy decisions, for instance regarding the location of expensive medical equipment and the public’s access to health care.

Let us then turn to justice on the operative level. As I noted earlier, firefighters will be facing situations in which triage, the sorting of casual-ties and efficient allocation of scarce resources, is required.

There are two main views on what constitutes just triage.7 The first is utilitarian triage. According to a utilitarian triage principle, we should distribute available resources as to maximise the total amount of a given good. The good might be well-being (as in classical hedonistic utilitarian-ism), lives saved, Quality-Adjusted Life-Years (QALYs), or something similar. The second view is egalitarian triage. According to an egalitarian triage principle, we should distribute available resources in order to pro-mote equality, for instance through ensuring that everyone who can be saved has an equal chance of actually being saved, even if that means that




the total number of lives saved might be lower than it could have been. Egalitarian triage, for example, might consist in setting up a lottery.

Utilitarian triage and egalitarian triage are two extremes. There are also mixed forms of triage principles, such as different versions of pri-oritarianism. I will not dwell upon these forms of triage here.

At least with regard to triage of life and limb, I believe that there is a strong case for adopting a utilitarian conception of justice in operative firefighting. If firefighters have a choice between saving one and saving three, they should, in most cases, save three. There are at least three rea-sons for adopting the utilitarian approach here.

First, the approach has intuitive appeal. This might not be the stron-gest of reasons, but it may in part explain that, secondly, a utilitarian principle of triage in extreme situations enjoys widespread support. To most firefighters, the idea of not applying a utilitarian principle of triage would appear absurd. This is not to say that such a principle should be accepted uncritically and in every situation, but it seems that in the case of firefighting those who argue for non-utilitarian principles for triage have the burden of proof. Thirdly, the principle is simple enough to be roughly implementable. Consider a possible alternative strategy. It has been suggested that in some cases, triage-like decisions should be made using a lottery. The argument for such a strategy is that it is considered fair according to some conceptions (Peterson 2008).8 The problem – or rather, one problem – with such an approach is that it is too complex and time consuming to be implemented in operative situations. There will be no time to set up a lottery or even to simply flip a coin.

Thus, on the operative level, there are prima facie reasons for adopting a utilitarian conception of justice, at least with regard to life and limb. Let us now turn to the policy level.

In parallel to the debate about justice in health care, two main stand-points can be imagined. The first is equal access to aid from the fire and rescue service, and the second is a decent minimum of aid from the fire and rescue service. There is a difference here between firefighting and




health care, however. ‘Health care’ can refer to anything from very basic medical examinations and treatments to advanced, high-tech and immensely expensive ones. The difference between ‘basic’ firefighting and state-of-the art firefighting is arguably less than it is in health care. (This holds within developed societies. Of course, there is a huge difference between a bucket brigade and a modern fire and rescue service.) Consequently, there are no incentives for the ‘luxury consumption’ of firefighting.

This means that the difference between equal entitlement and decent minimum aid is not huge in terms of services received (lives saved, fire put out, damage minimised). However, there are obvious problems in ensuring equal access to aid from the fire and rescue service. The reason is that firefighting has to be undertaken promptly to be efficient. If the firefighters arrive at a burning building after an hour or two, it will often be too late. A crucial factor here is geographical distance to the fire sta-tion. For example, I live in a city and I have called the emergency services once after smelling smoke on the stairway. The firefighters arrived after just a few minutes and after a thorough search of the building they con-cluded that, fortunately, there was no fire. Had the same thing happened to someone living in a very small village in the countryside, it would have taken the firefighters significantly longer to get there. This means that from a practical point of view, completely equal access to aid from the fire and rescue service is not feasible. Arguably, however, a decent mini-mum of aid can be guaranteed, and the difference between this and full access to a city’s fire and rescue service need not be enormous.

A decent minimum of aid could be brought about in several ways, of which I will mention two:

First, support could be given to local volunteer firefighters. For exam-ple, in sparsely populated areas in Sweden, ‘fire guard’ teams are organised. (Similar organisations exist in many other countries as well.) Somewhat analogous to the military’s Home Guard, fire guards consist of locally recruited members who are called out by telephone or pager in case of a fire or accident. The fire guards have older, less sophisticated equipment




than regular firefighters, and they have less training, but they are typically able to respond quickly to fires and accidents in their neighbourhood, and may be able to save lives and reduce damage to health, property and the environment before the regular fire and rescue service can arrive.

Second, fire extinguishers and sprinkler systems could perhaps be subsidised in areas where the regular fire and rescue service cannot be expected to respond quickly enough. The same holds for escape ladders and smoke detectors. Smoke detectors, in particular, are inexpensive, low-maintenance and easily installed, and thus cost-effective. In some jurisdic-tions smoke detectors are compulsory. This is the case in Sweden (in non-binding legislation).

Still, one may ask whether everyone can claim even a minimum of aid from the fire and rescue service. Consider an arsonist who takes great pleasure in watching firefighters at work. The arsonist is also rich and buys a large industrial estate outside the city where he lives. He sets fire to one of his own buildings, calls the fire and rescue service, sits back, relaxes and enjoys the sight. It seems that the arsonist here is not obvi-ously entitled to assistance from the fire and rescue service, but the obvi-ous objection is that the arsonist does not need firefighting in any relevant sense. He desires it, but he does not need it. If, on the other hand, he chose to place himself in the building, so that he would be burned to death unless the fire is put out, he does need aid from the fire and rescue service. He has rather ingenuously created a need. In this case, he should be given aid to save his life, though not necessarily his property.

Nevertheless, from a purely practical point of view, the fire and rescue service should put out the arsonist’s fire. This is because there are other relevant considerations involved. The fire might spread and the smoke might be harmful to people or the environment. Furthermore, there is considerable uncertainty about the situation. Is the building really empty? Even though the arsonist assures us that it is empty, he is perhaps not to be trusted. For instance, a couple of children might have sneaked into the building unseen to play, or a hobo might be hiding in the basement.




V. CONCLUSION

The ethics of firefighting is a seriously unexplored topic. This is regrettable, since firefighting is about safeguarding things of great social and moral importance, and also might have implications for moral theorizing.

This need for the study of firefighting ethics in its own right is high-lighted by a comparison between the ethics of firefighting and the ethics of medicine. There are many similarities between firefighting ethics and medical ethics. For instance, firefighting and medicine alike sometimes require quick decisions under difficult conditions and in both areas triage will have to be carried out.

However, there are also important differences. First, firefighting is less professionalized than medicine, since firefighters rarely receive formal training to the same extent as medical personnel do. Second, the care-giver-patient relationship is not as central in firefighting as it is in medi-cine, and it is typically more transient. Third, firefighters need to concern themselves with other values than life and limb, for instance property and the environment. Fourth, firefighters also face greater risks and qualita-tively different types of risk than medical personnel. Finally, firefighters have to make almost every operative decision under conditions of tem-poral stress, with limited possibilities for consultation with colleagues, ethics committees, and the like.

The fact that medical ethics and firefighting ethics are closely related but nevertheless different means that some elements from the former might be adapted for use in the latter. This can be seen from my applica-tion of the four mid-level principles from mainstream medical ethics of autonomy, non-maleficence, beneficence, and justice to firefighting eth-ics. These principles are applicable in firefighting ethics, but they need modification and their relative weight is different. Respect for autonomy will be of limited importance in firefighting. Non-maleficence is impor-tant, and beneficence is central. Arguably, beneficence is the very ratio-nale of firefighting. The special principle of beneficence for firefighters




is best thought of as grounded in firefighters’ contractual obligations rather than in a general principle that one should help someone in peril.

As regards the principle of justice, there is a case for applying a utilitarian principle of justice on the operative level. There are three rea-sons for this: the approach has intuitive appeal, it is widely accepted, and it is practically implementable. On the policy level, we should apply a principle of a decent minimum of aid rather than a principle of equal access to aid from the fire service. Completely equal access is not practi-cally feasible. A decent minimum of aid can be brought about by com-paratively simple and low-cost means, such as fire guards and subsidized fire equipment in areas where response times of the regular fire service will be long.

Much work remains to be done in firefighting ethics. Hopefully, this article has shown that the project is both justified and feasible.

ACKNOWLEDGEMENTS

Earlier versions of this paper were presented at seminars in the Depart-ment of Philosophy and the History of Technology, Royal Institute of Technology, Stockholm and at the Centre for Applied Philosophy and Public Ethics, Australian National University, Canberra. The author wishes to thank Anders Bergqvist, the editors and two anonymous refer-ees for helpful comments. The research behind this paper was supported by the Swedish Emergency Management Agency. This support is grate-fully acknowledged. All views are those of the author.

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NOTES

1. For policing, see, for example, the issues raised in Miller, Blackler and Alexandra 2006. For the military, see, for example, Hartle (2004).

2. A comprehensive and still remarkably up-to-date treatment of triage can be found in Winslow (1982).

3. This is not to say that it is non-existent. See, for example, Sandman and Nordmark (2006).

4. See Desmond (2007).5. Cf. Brecher (1985).6. Cf. Becker and Eagly (2004).7. Cf. Tännsjö (2007).8. For some real-life examples, see Childress (2003).


firefighting ethics: principlism for burning issues

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