Rescue as an ethical dilemma?

Gunkiemike wrote:I've seen spinal fractures. There ain't no "crawling back to the car" with a busted spine.

Yes there is. I had a fracture of my 4th lumbar vertebre and did a short walk out. Doctor's said it was not advised because I could have injured it worse. But I was so embarassed having decked, I thought I'd better suck it up and try. Thanks to Ken Trout and partner who helped carry the gear close to the vehicle!

"'I guess we must be on two different mindsets. Someone else can probably offer more insight here.'"

Mark, can't win an argument with someone who knows it all.

Seems as though this topic has so many different scenarios it's almost impossible to predict the nature, demands, and outcomes of every "emergency" situation.

IE.... There is a couple who are doing a world motorcycle tour. The guy had a bad crash in Brazil, fractured his spine. Yet the couple still managed to ride their moto's to a large enough city to get medical assistance.

Last year I took a fall at Lumpy, broke my ankle, partner and I made it out under our own steam. Had to leave gear on the wall (wished I could have gotten my gear back, but hey wasn't the top priority at the time) Someone else with less medical training or couldn't keep their wits about them may have called in the accident to 911.

I think risk and the potential of accidents are mitigated by experience and knowledge. But weird shit happens that you cannot account for.

"'Think about this, climbers don't have to climb, so when they do get injured when something happens, yes it is their fault.'"

Yup, mine and my Climbing partners fault for the rock from above that hit us at the belay. LMFAO!!!!!

Mi dos centavos,
Juan

I've been a climber for 20+ years, doing mountain rescue for a little over 10 years and worked as a Paramedic on an ambulance for about 4. I'll add my personal perspective on this (to be clear: this is my opinion, and does not represent the mountain rescue team I am a part of, or the larger mountain rescue community).

While on the ambulance, I responded (i.e. lights and sirens, running red lights, etc.) to 911 calls for broken wrists, sprained ankles, chronic conditions that hadn't changed in weeks, and even once for a paper-cut. It used to drive me nuts that people would call 911 for some of these things. I eventually came to believe that everyone has a different threshold for what sort of challenges they can handle. People who can handle stressful situations will think that people who can't are lame for calling 911 for a situation that seems like no big deal to them. But the point is that the person who asked for help realized that they were in over their heads and couldn't solve the situation by themselves. This mindset made it easier for me to respond to a situation that seemed trivial to me. It wasn't a waste of time. This person needed help.

As a society, we have decided to have things like police, fire, ambulance, and rescue services to help out in these situations. These services are sometimes abused by people that didn't really need the help -- they were just being lazy. But I think that is less prevalent than you might think -- at least in the ambulance/rescue world that I have been involved with.

As a climber I've always felt that I should do everything I can to avoid rescue. I'm with Stich, in that I will do everything I can to solve my own problem unless "life or limb" is at stake. If I broke my ankle or wrist in a lead fall in Eldo, I'd like to think my partner and I could get out under our own power. Maybe we even recruit a few nearby climbers to help us out. But I don't think I'd need the rescue team to come get me. I've spent a lot of time learning the medical and technical skills needed to get myself out of that situation.

But, that does not mean that I think other people must have the same threshold as I do for initiating a request for the mountain rescue team to respond. As a mountain rescuer, I'm happy to respond to someone who needs assistance, even if the situation is not one that would have prompted me to call. The situation has exceeded their capacity to handle it, and therefore they need some help. That is what I joined the mountain rescue team to do. It is a volunteer organization. I'm not being forced to go get them. I do it because I want to be able to help others when they need it.

Others have raised the question of whether we are putting rescuers at risk by calling for a rescue. Yes, at some level I must acknowledge that going on a rescue is more risky than staying at home, hiding under the couch. But it is not more risky than what I do every day. I spent the weekend whipping off sport climbs in the Flatirons, and climbing multi-pitch in Eldo. Mountain rescue is not more dangerous than either of those activities.

Rescuers of all types (fire, ambulance, mountain rescue) will always put their own safety first. It's a rule you get taught in all of your training classes. You can't help someone else if you get hurt or killed trying to get them. I won't do anything on a rescue that I wouldn't do on my day off. It gets tricky when someone is injured on top of a peak in an electrical storm, or is injured in an avalanche in an area with potential for other avalanches to hit rescuers as they try to get to the victim. There's no easy answer to how these are managed, other than to say that I will always do my best to get to you, but I'm not going to get killed trying. At some level, we all assume the risk of the activities we choose to participate in. And if I'm the one that kept climbing up into the pending electrical storm, I have assumed the risk of that situation. I hope someone will come help me (if I call) as soon as they can, but I don't want anyone to get killed trying.

As a climber I've tried to raise the threshold pretty high for what it would take for me to need help. I've taken wilderness first-aid courses and practiced the self-rescue rope skills (and shared this knowledge with other climbing partners). I appreciate/respect it when other climbers have done the same. But I am also willing to help people that haven't. They made a mistake and got in over their heads. We all do in one way or another every now and then (maybe not in climbing, but in something else). And if you haven't gotten in over your head at least once in your life, maybe you aren't pushing yourself hard enough. My life has been enriched by the risks/challenges I have taken on, and I wouldn't want to live in a world that aggressively discouraged risk-taking at any level.

There's a great quote from the Southern hardman Jeep Gaskin in the current issue of Rock and Ice: "If you have depth to your soul and insights into life's lessons and you didn't get them from risk, then congratulations, but I can't relate".

We should try to be prepared to deal with the consequences of the risks we take. But the nature of risk is that sometimes the consequences may be more than we can handle.

no1nprtclr wrote:"'Think about this, climbers don't have to climb, so when they do get injured when something happens, yes it is their fault.'" Yup, mine and my Climbing partners fault for the rock from above that hit us at the belay. LMFAO!!!!! Mi dos centavos, Juan

It was your choice to stand at the base of a cliff where rock can fall, yes your fault.

TomCaldwell wrote: It was your choice to stand at the base of a cliff where rock can fall, yes your fault.

That's silly... since the rockfall was likely caused by someone at the top of the cliff, that is like saying it is my fault if someone drives into my living room and hits me sitting on my couch... since 'it was my choice' to sit in my living room where someone could drive through the wall, yes my fault

Tim Zander wrote: That's silly... since the rockfall was likely caused by someone at the top of the cliff, that is like saying it is my fault if someone drives into my living room and hits me sitting on my couch... since 'it was my choice' to sit in my living room where someone could drive through the wall, yes my fault

Do people frequently drive into your living room, no. Does rock frequently fall from the top of mountains, yes.

It is not completely the fault of the climber standing at the bottom of the cliff when someone accidentally or intentionally sends the rock down, but assume some risk! There is scree at the top of the cliff, don't expect it not to come down when you are standing at the base.

"because climbers are viewed as an un-neccesary group of risk takers costing taxpayers for rescues. Pain is not life-threatening and therefore not an emergency."

Really? In my neck of the woods the people who are always getting publicity for getting themselves in a bad situation are usually snowmobilers or hunters. And pain can be life threatening if it causes the person to go into shock.

I agree with Rich as far as people having a different threshold for pain. I do however think that they need to come up with a way to determine fault in a rescue. For example: If some guy is hiking and just so happens to stumble and break his leg, then that's just tough luck and he wouldn't be charged. But if someone else were to go out and get lost because they didn't bring a map and aren't familiar with the area and end up falling off a small cliff, then I think they should be charged for the rescue. How to actually determine this brings up a whole other issue though.

First off... Rich's post above is spot on. For the people claiming that pain is not a reason for a rescue... do you think most climbers can determine which pain is life threatening and which is benign?

A fractured femur sure hurts and can bleed internally enough to kill you. A fractured humerus might hurt the same and is unlikely to kill you. A single side spinal fracture hurts and you might crawl out fine. Break both sides of the spine and you're risking paralysis. Concussions suck. Concussions and epidural bleed kill. How many of us know how to tell the difference?

My opinion: Try as hard as you can to self rescue. If you think you're in the poop then call the heroes. If you're not sure... call the heroes. It's easier to rescue a mentating victim during the day than a half dead victim in the middle of the night!

Die with Honor, you will be a hero!!!

On a serious note, Thanks to the people that do sacrifice there time and risk to help a troubled party!

Why is a rescue in the mountains any different then relying on ALS in town or on the road. You take the risk to drive your car, but if you are in an accident ALS is there to help and fast. So should you be responsible to take all rescue into your own hands if you drive your car and not rely on an ambulance if someone slams into you on the road? By all means don't call it in if you don't need it, but train yourself to make that assessment in the field and fast.

As far as rescue goes, Proper self rescue skills and medical training is overlooked by so many outdoor enthusiasts, in all areas of the mountains, not just climbers. I wish I had a dollar for everytime I climbed with someone who didn't know how to escape a belay.

If you really want to help and contribute to minimizing the need for a called in rescue, then take a WFR or WFA at a minimum. Get some training and learn how to self rescue with your own gear. After your training, practice it. If every climber did this, then I am sure we wouldn't eliminate Rescue calls for climbers, but we sure might be able to minimize it. With that baseline training, you would at least be able to make a better assessment in the field as to whether the situation was life threatening or not. More importantly, Does the patient need immediate evac, or a slow evac. Can it be done alone or does it need assistance. Can you release someones spine in the field on your own? I think climbers owe it to themselves, their partners and what the general public view is on rescues for climbers to get wilderness medical training and Climber Self rescue training.

That's the least you can do to contribute to the teams that do lay it on the line to help, My 2 cents

JPVallone wrote:As far as rescue goes, Proper self rescue skills and medical training is overlooked by so many outdoor enthusiasts, in all areas of the mountains, not just climbers. I wish I had a dollar for everytime I climbed with someone who didn't know how to escape a belay. If you really want to help and contribute to minimizing the need for a called in rescue, then take a WFR or WFA at a minimum. Get some training and learn how to self rescue with your own gear. After your training, practice it. If every climber did this, then I am sure we wouldn't eliminate Rescue calls for climbers, but we sure might be able to minimize it. With that baseline training, you would at least be able to make a better assessment in the field as to whether the situation was life threatening or not. More importantly, Does the patient need immediate evac, or a slow evac. Can it be done alone or does it need assistance. Can you release someones spine in the field on your own? I think climbers owe it to themselves, their partners and what the general public view is on rescues for climbers to get wilderness medical training and Climber Self rescue training. That's the least you can do to contribute to the teams that do lay it on the line to help, My 2 cents

+1 Completely agree. Your local guides offer single and multi-pitch rescue course all the time. We took ours from Fox and wouldn't go to certain places until we did. Back to the OP's original question, the public view of us is important, so yes it can cause an ethical dilemma, but a rescue should still be available if you need it.

TomCaldwell wrote:You should be able to do an assisted rappel with another person regardless of their pain or consciousness.

My friend was in such intense pain that we couldn't even get her to change from a seated position to a prone one. Before that day I would have assumed what you said is correct. It isn't. But oh, I see you are one of those "leave the phone on the ground" types too proud to call for a rescue. I believe that was the same situation someone who posts here ran into in Alaska. Too proud to bring a radio back then it was, so down the partner rappelled for hours until just by a stroke of luck the bush pilot made a pass and he was seen. Otherwise his buddy would have been a dead popsickle. But yeah, they didn't bring that radio and style is what counts.

Rich's response was right on! As a member of another mountain rescue team here in Colorado, I'd like to add my two cents (again: this is my personal opinion and does not represent the opinion of our mountain rescue team).

We in the search and rescue world try so hard to advocate the principles of "no charge for rescue." It's a common myth that we are trying to de-bunk that if you get rescued, you will be billed. In Colorado, the majority of rescue operations come at no charge to the patient (the exception to this is if a paramedic provides pre-hospital care, then there is likely a fee for that, but that is usually covered under medical insurance). And since the majority of rescue teams are all volunteer, they do not necessarily cost the tax-payers anything. Many folks think that since they have a hunting/fishing license, they get one free rescue. Myth. Almost all rescues are free (see exception above).

The reason we are trying to get this message across is that all too often, people get into trouble and they delay calling for help, thinking that they don't want to foot the bill of the rescue. Then once night falls and they are in REAL trouble, it complicates the rescue immensely. We would much rather you call for help, even if the injury is questionable. There is no shame in calling for help. Several of the top members of our rescue team have been rescued themselves in years past.

Unfortunately, there is no magic answer for when you should call and when you shouldn't. Perhaps the best answer is: if you are questioning whether or not you should make the call... CALL 911! Often times, your location can be reasonably determined from your call to 911 (using magic and GPS). If you can still move ok under your own power and are convinced there are no spinal injuries, it will just make the rescue operation easier. If you took a hard fall, hit your head, or anything that could compromise a spinal chord, better be safe than sorry.

We train extensively year round at rescues of all sorts (including mid-wall litter loads of patients with neck/back injuries). If your partner is incapacitated (for whatever reason) and is dangling mid-wall, if you can lower them to the ground safely, that is generally advisable, but if you have any doubt, rest assured there are loads of qualified rescue personnel that can handle any situation. Besides, we love doing this and I get to leave work to rescue people in trouble (please don't tell my boss)!

I'd be happy to answer any questions folks might have about the rescue industry.

TomCaldwell wrote: +1 Completely agree. Your local guides offer single and multi-pitch rescue course all the time. We took ours from Fox and wouldn't go to certain places until we did. Back to the OP's original question, the public view of us is important, so yes it can cause an ethical dilemma, but a rescue should still be available if you need it.

You quote the section about WFR, etc and still think pain may not be an issue worth rescue? I really question that thought. After taking going working through some hairy situations I side with Rich's statement. What I find trivial may be hell for someone else. I would soon them give the call then make things worse for themselves and/or those who will have to clean up the mess because of he/she tried to be the hero.

T. Maino wrote: A fractured femur sure hurts and can bleed internally enough to kill you. A fractured humerus might hurt the same and is unlikely to kill you. A single side spinal fracture hurts and you might crawl out fine. Break both sides of the spine and you're risking paralysis. Concussions suck. Concussions and epidural bleed kill. How many of us know how to tell the difference?

Most people don't have a doctors degree, x-ray machine, and cat scan machine to be able to do this.

TomCaldwell wrote:Carrying a cell up the climb makes the decision to call out too easy, leave it on the ground.

YOU might be fine when you have to shiver biver on a ledge, but when you don't show up at home on time, and your loved ones calls SAR, they still get to spend the night looking for you.
Bring the phone, turn it off, and forget about it unless you need it.

It is funny hearing encouragement for people to make rescue calls from those in the rescue industry. You have a personal interest to support your job, your opinion is biased. My main contention with the rescue call is that the person is probably in over their head before the situation even arose. The comment on the WFR or rescue course only means to get more educated so you don't have to call for help, because calling for help in many areas is an ethical dilemma. Obviously as been stated there are situations where a call would need to be made, thanks for all the scenarios but the OP was asking about the ethical issue. Access can and will get shut down. That point can't be denied, because it has happened (even in your home state CO). I took pride in learning the proper skills, I don't take pride in leaving the phone on the ground. Leaving the phone is part of the adventure and assumption of the risk. This obviously is different in an alpine setting where a support crew is there for that specific purpose in regards to the Alaska reference.

Look at the story just this spring at the Red Rock Rendezvous. Where all those people with no self-rescue skills got stuck on the solar slab. Had phones called it in, but rescue couldn't do anything until the weather cleared. A few people almost died of hypothermia after being stuck on the wall for hours. Call it in if you get jacked up, but not just because you don't have enough technical rope skills. Know your limits.

Stich, didn't your friend have to move when rescue personnel got there? What is the difference in waiting for rescue personnel to get there and expediting the process by getting them to the ground while waiting for a rescue to show up?

(following not in response to anything specifically posted)

If anyone pragmatically goes through this topic, reasonably weighs out the situation, sees a possible serious medical concern, tries to solve the problem but can't, and then comes to the decision that you probably should call something in, yes, you more than likely do need help.

Usually, people that take the time to go into a topic like this are not the problem of when to call something in; just as they would not be the problem for self-rescue clinics, belay & anchors skills, some sense of climber's safety education, etc.

Not that I'm anyone's judge, but if I were --- When you hit the plb because you were afraid of the thunder just to make a video blog of your so-called epic in the mountains, yes, you're a moron.

rescue industry? i don't know of too many people who get paid for (climbing) rescue work. i think one of the points that several are trying to make (i know mark nelson has made this point in other threads as well) is that if you are trying to self rescue in a "borderline" situation and it doesn't pan out, you could be putting yourself in a bigger pickle than if you had just asked for help in the first place.

it would be interesting to see the similarities/differences in opinion between 2 partners on a route. perhaps one might be a self rescue or die person, and the other might be dialing for the heli-evac in a heartbeat. i tend towards trying to self rescue if possible/practical, but if i was in a situation where my partner was injured pretty bad i wouldn't hesitate to call for help if they felt that was necessary.

also another comment, even if you aren't in over your head before the situation arises, you will be in over your head if the situation arises. that's just how it works some times.

My $0.02 since I just started a thread about them...

I also like to think I can get myself out of most all situations I get myself into but if I need a rescue I'd like to be rescued. The problem is (at least around here, and I am one so I can say this) is that the fire service rope rescue protocols are about 15 years behind the times. I can pull of a safe efficient rescue in less than half the time it would take for any of the local technical rescue teams with less than half the people and half the gear. Unfortunately it's a budget issue and that will never change.