Roy and Johnny are at the hospital talking to nursing staff enjoying a moment of downtime in the mist of a very busy shift. The radio comes alive “Medic 1 respond for an injured person on the street, 1208 O’Donnell Street, the time is 127hours, Medic 1 acknowledge”. Johnny grabs his portable and responds, “Medic 1 responding. The two paramedics start their unit, flip on the lights and are off headed to the bar district of the city at 1:30am looking for an injured person on the street. The two medics think about what it could be ? Roy says, “You know this is probably a bar fight and we get the loser” They both laughed. Arriving on location they meet the police who inform them they can’t find anyone. After asking communication for any further information they drive around investigating. They would hate to have the patient found unconscious in someones yard. Johnny catches a glimpse of a person sitting in an alley.

Johnny :“Stop, I found him”

Roy :“How do you know ? “

Johnny:“Who else would be sitting in an alley covered in blood, but our patient ?”

Roy : “Good point”

Roy backs Medic One up so that the scene lights illuminated the alley and calls communication to give and updated location and request police. As the two paramedics approached the patient they find him covered in blood cutting himself with a broken bottle. Roy the lead medic asked, “Sir what is going on tonight ?” Just then the patient stands up, screams and charges Roy attempting to stab him with the bottle…

Duty to retreat and Use force what are they and how does it affect EMS providers ?

Duty to retreat is a specific component which sometimes appears in doctrines governing self-defense, and must be addressed if the defendant is to prove that his or her conduct was justified. Some jurisdictions where the requirement exists, the burden of proof is on the defense to show they acted reasonably chiefly by demonstration that all necessary steps where taken to avoid a physical confrontation. Secondly showing that you took all reasonable steps to leave the situation thus demonstrating your intention not to fight before being driven to using force.

Use of force describes a right of an individual to defend against, settle a physical altercation or prophetically prevent a violent encounter. The use of force may be used to discourage an attack or to terminate a continued attack. In the United States the governments allow police, citizens, or other public safety personnel to employ force to actively prevent imminent attacks or the commission of a crime and even for deterrence.

I am not a lawyer so I am only conveying information that has been conveyed to me please don’t take my word as gospel. In the scenario does Roy have a duty to retreat before he defends himself ? Regrettably I believe he does, if he can. We are not law enforcement and are not trained to defuse violent encounters. I have seen it in my career medics get into very serious trouble because they stayed in a situation instead of retreating. I remember an instructor telling me years ago that we [EMS providers ] have an obligation to go into a situation but no obligation to stay if our safety is at risk.

Roy’s first responsibility would be to call the police which he did when he arrived and if he could retreat to the ambulance or beyond. The challenge will be physiological. Under extreme stress fine motor skills do not exist, so trying to operate the unlocking handle on a door is gonna be tough.

Assuming Roy is unable to retreat and must use force in defense of his life, then what ? I was taught and I teach all my students to avoid confrontation at all cost. If they must fight use only the minimal of force necessary to withdraw from the confrontation. The Samurai had what they called the hierarchy force doctrine which stated when using force in defense of ones self and individual had an ethical duty to retreat before restrain, restrain before injure ,injure before maim, maim before kill and kill only as a last resort. One of my favorite authorities on this topic is Jim Wagner who developed THE JIM WAGNER USE-OF-FORCE LADDER™ .

Quote Jim Wagner

Being a civilian who is learning personal protection does not isolate you from the law. Ignorance of the laws of the land is not a legal excuse that will protect you, especially when it comes to excessive force cases. Most civilian martial artists have no idea just how much trouble they can get into legally, even when they, in good faith, were just trying to protect themselves or someone else. There are a few well meaning martial artists right now sitting in prison, because they didn’t know where to draw the line, or even where the line was at in the first place when it came to the use of force. This is why I created the Use-of-Force Ladder for Civilian Self Defense™. Although “the ladder” is similar in concept to what the military and civilian law enforcement agencies must follow, my ladder is specifically designed for civilians.

Jim Wagner’s theory clearly defines the levels of threat a person is facing and an equally appropriate response level to that threat. Use of Force Ladder and the Samurai Use of Force doctrine do not differ dramatically, what Wagner’s theory does do very well is articulate exactly what an appropriate civilian use of force response is to particular threats.

Example1: If someone is talking aggressively but has not made any physically threatening gestures. This is a threat level 2 and can be defended appropriately with a confident demeanor or verbal deflection.

Example 2: Roy finds is in a threat level 3 situation where reasonable force may be used . We discussed last week what is defined by “reasonable force”.

I recommend that you read more of Jim Wagner’s writings he is very well versed on this subject and other self defense topics.

Back to the alley:

Roy was caught by surprise and backs up to leave but his retreat is blocked by a fence and two cars. The patient closes in fast with the broken bottle raised above his head in a stabbing motion. Roy just reacted and grabbed the patient’s wrist, like he has done in class many times over the years and led him to the ground and disarmed the bottle from his hands. He was uninjured and the patient received no injuries. The police arrived just after the confrontation which only took seconds to unfold and arrested him. The patient was transported to the local ER and detained for a 72 hour psych evaluation.

Next week we will continue our exploration of Self defense doctrine and EMS.

Enjoy the introductory episode of Self Defense for the EMS provider.

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