My Emergency Is Not Your Entertainment: Professional Ethics and Reality TV

To start off, let’s just imagine…

To start today’s post, I want to begin with a hypothetical scenario, a little thought experiment if you will.

Imagine that one of your loved ones is unwell. Not just a little unwell, but significantly unwell. So much so, you have concerns for their life. This might be a child experiencing a first-time seizure, a partner with anaphylaxis or, at the most extreme end of this spectrum, one of your loved ones may have had a cardiac arrest. Apologies, this isn’t a pleasant thought experiment.

For some, this may be something you have experienced before – the terrifying prospect of having to call for emergency help for a loved one, left feeling almost helpless while you wait for help to arrive. For others, this may be purely hypothetical. For those of us who are parents, it is at the very least something you have likely thought about among the many fears parenthood brings.

Back to the scenario.

You call 000 and experience the seemingly eternal wait that is the roughly 10-16 minute median response time for an ambulance across Australia.¹

Help finally arrives.

In walks the first paramedic, the second paramedic and then, unexpectedly, a film crew. You’re perplexed. Who is this person, and why are they here? That thought is fleeting, though, as your mind immediately returns to your loved one inside. You usher the paramedics inside your home, film crew in tow, inviting these strangers into the most intimate spaces in your life, during what is the worst day of your life so far.

The paramedics get to work straight away. They are caring and supportive, but you can’t help but notice the cameras as they work, filming everything. As things progress, tears are shed, deep emotions expressed and difficult, personal and clinical discussions are had. Your loved one is bundled into the ambulance, and, again, you can’t help but notice the cameras mounted inside. As emotions settle, you increasingly feel reassured that the paramedics have everything under control. Still, as you begin to calm, you can’t help but now notice that the paramedics themselves are wearing body-mounted cameras.

After arrival at the hospital, you ponder what has just happened. Then, sometime later, you are contacted by the film crew, asking whether you would consent to the footage being used in the latest season of a hit ambulance reality TV show.

Feel free to stop here a second and ponder this hypothetical, really think about it.

A note on today’s post (click to expand)

Today’s post is fairly direct and pointed. I acknowledge that in the limited discussion I have encountered on this topic, there is some disagreement about the appropriateness of these television programmes, and I have attempted to address the substantive arguments that have been put to me in their support.

I also recognise that paramedics I respect have participated in these programmes. Although I strongly disagree with the ethics of that involvement, my criticism is directed at the practice and the systems that enable it, not at the character or professionalism of individual clinicians.

Finally, I should also acknowledge that several parts of this post have been adapted from correspondence with the leadership of ambulance services, in which I outline my concerns about their involvement in such a programme.

Have we actually stopped to ask if reality TV belongs in paramedicine?

Reality TV shows featuring interesting jobs are nothing new, and many of us will remember the days of Ice Road Truckers, Deadliest Catch, and, for my fellow Kiwis, there is always the iconic Police 10-7. Ambulance shows have featured among these, including Ambulance Australia, Paramedics, Emergency Rescue Down Under… the list goes on and on (see Table 1 below).

These shows have been around in some form or another my entire career. Still, it has seemed to me that in the past few years, at least post-COVID (which, by the way, if you want to feel old, was nearly half a decade ago now), there has been a resurgence in the number of programmes on air featuring ambulance services across Australia and Aotearoa New Zealand. But admittedly, this may be an awareness bias on my part, so I did what any academic with no real spare time would do – I spent an evening trawling the internet gathering data for analysis.

As we can see in the Figure below, at least in Australia and Aotearoa, these shows appear to have peaked in the mid-2010s and then dropped sharply after 2018. Whether that drop was related to professional registration, audience preferences or something else is unclear. Either way, it appears these shows may be making a comeback, or at the very least, aren’t going away on their own.

Table 1: Detailed Data Table (click to expand)

Table 1 – Factual television programmes featuring frontline ambulance or helicopter emergency medical service personnel in Australia and Aotearoa New Zealand, 2000–2026

Programme	Country	Ambulance/HEMS content	Original Network	No. Seasons	Years Initially Aired*
Choppers	Aotearoa New Zealand	Rescue helicopter service crews, including paramedics/medics, followed during real helicopter rescue and medical responses	TV2	2	2001, 2002
Priority 1 – Middlemore	Aotearoa New Zealand	Order of St John ambulance officers followed on frontline responses, with patients subsequently followed into Middlemore Hospital	TVNZ/TV2	1	2001
Medical Emergency	Australia	Metropolitan Ambulance Service/Ambulance Victoria ground and air paramedics followed during frontline responses alongside Alfred Hospital emergency and trauma care	Seven Network	5	2005, 2006, 2007, 2008, 2009
HELP	Australia	NSW Ambulance officers and paramedics followed on frontline emergency responses, including use of crew-mounted cameras	SBS One	1	2006
Chopper Rescue	Australia	Emergency Management Queensland helicopter crews, including paramedics and emergency doctors, followed during rescue and medical missions	ABC TV	2	2008, 2011
Rapid Response	Aotearoa New Zealand	St John Ambulance ground ambulance and rapid-response paramedics attending real medical emergencies	TV One	7	2008, 2009, 2010, 2012, 2013, 2014, 2015
Emergency Heroes	Aotearoa New Zealand	Ambulance, Police and Fire personnel followed during frontline emergency responses	TV3	1†	2009
Rescue 1 (Chopper Squad)	Aotearoa New Zealand	Auckland Westpac Rescue Helicopter pilots, crew and paramedics attending emergency and rescue missions	TV2	4	2009, 2010, 2011, 2012
111 Emergency	Aotearoa New Zealand	Ambulance, Police and Fire services, with cameras embedded in ambulances and other emergency vehicles	TV3	1	2011
Recruits: Paramedics	Australia	NSW Ambulance trainee paramedics followed through training and their first operational frontline shifts	Network Ten	1	2011
Air Rescue	Australia	Westpac Lifesaver Rescue Helicopter Service pilots, aircrew and intensive care paramedics followed during real missions	Seven Network	5	2013, 2014, 2015, 2016, 2017
Code 1	Aotearoa New Zealand	Auckland Westpac Rescue Helicopter paramedics, emergency doctors and flight crews attending real missions	TV2 / TVNZ 1	5	2013, 2014, 2015, 2016, 2017
Helicopter Heroes Down Under	Australia	Australian rescue helicopter and aeromedical teams followed during frontline HEMS and rescue missions	BBC Two / BBC One	2‡	2013, 2015
Life Flight	Aotearoa New Zealand	Westpac Rescue Helicopter and aeromedical retrieval crews attending rescue and medical missions	TV One	2	2013, 2016
Street Hospital	Aotearoa New Zealand	Wellington Free Ambulance medics and paramedics providing frontline care in central Wellington	TV2	2	2013, 2016
I Heart My People	Australia	Queensland Ambulance Service paramedic and Emergency Management Queensland rescue helicopter clinician followed operationally within a broader Indigenous health series	NITV	1	2014
Gold Coast Medical	Australia	Queensland Ambulance Service paramedics followed on triple-zero emergency responses alongside Gold Coast University Hospital personnel	Seven Network	1	2016
Ambulance Australia	Australia	NSW Ambulance and Queensland Ambulance Service paramedics, specialist clinicians, call-takers and dispatchers followed during frontline operations	Network 10	5	2018, 2019, 2020, 2022, 2024
Paramedics	Australia	Ambulance Victoria, SA Ambulance Service and St John WA ground ambulance, specialist-response and HEMS clinicians followed during frontline cases	Nine Network	7§	2018, 2020, 2021, 2022, 2024, 2025, 2026
First Responders	Aotearoa New Zealand	Ground ambulance paramedics, critical-care paramedics and rescue helicopter crews alongside other emergency services	TVNZ 1 / Three	3	2022, 2024, 2026
Our Medicine	Australia	Queensland Ambulance Service paramedics followed during frontline call-outs within a broader series examining First Nations healthcare professionals	NITV / SBS	2	2025, 2026

These shows are usually filmed by commercial entities in collaboration with ambulance services, and, presumably, the paramedics who are filmed consent to their involvement. Despite ongoing involvement by organisations and a few paramedics, the acceptability of these shows at the profession level remains largely unexplored. At least I have seen little discourse, whether academic or informal, on the ethical or professional implications of these shows. However, regardless of the profession’s underlying approval or disapproval, it seems to me that filming these shows has been accepted as part of life, as evidenced above by their continued production.

The purpose of today’s post is to start this discourse, or at least encourage some robust professional consideration as to whether, as paramedicine continues to professionalise, involvement in these shows is ethical and congruent with our profession’s values and responsibilities to the public.

To be transparent, I will argue that paramedicine’s involvement in filming reality television directly conflicts with our core professional and ethical responsibilities.

The public trusts paramedics – not film crews

One of the greatest privileges of being a paramedic is the extraordinary trust the public places in us. Strangers allow us into their homes, often at their most vulnerable, with no prior relationship, no background check and, usually, very little hesitation. The trust that the public holds in our profession is something I find most, if not all, paramedics discuss with both pride and reverence. It is truly something unique the way paramedics are invited into the lives of strangers, and I often challenge my students to consider: when was the last time you invited a complete stranger into your home in the middle of the night, unvetted with no questions asked?

That privilege is not granted to us as individuals. It exists because of the deep public trust placed in the profession itself. At its core is an expectation that paramedics will act in the interests of the people who call us for help. Maintaining that trust requires, among other things, a strong commitment to ethical practice, confidentiality and respect for the dignity and autonomy of our patients.

I recently heard at a conference a paramedic talking about community trust say something along the lines of:

“that trust was earned by the person before me, and it’s my job to maintain it for those after me”.

That community trust is fragile and, crucially, is not automatically extended to third parties, such as a film crew. Patients call for an ambulance because they trust and need paramedics to provide medical care, not to have their emergency become part of a television production. Regardless of intent, a film crew is an additional presence in a private and distressing moment, who, unlike paramedics, were not invited and have no inherent trust with the patient.

It is this uninvited presence of a film crew in the first place that is my first issue with ambulance reality TV shows; a presence that piggybacks on the inherent, but fragile trust afforded to our profession, in a time of vulnerability and power imbalance.

We protect patients from media prying eyes – so why are film crews okay?

Confidentiality and privacy for our patients are core professional obligations.² Protecting this is not limited to whether we personally repeat what a patient tells us, but also requires us to consider who else we permit to be present when confidential information is disclosed and who is given access to circumstances from which sensitive information can readily be inferred. This also extends beyond clinical information. The condition of a person’s home, their appearance, conversations between family members and even the social factors related to the ambulance response are all details our patients can and should reasonably expect to remain private.

There is no question that the unpredictable and varied nature of paramedic practice can make confidentiality challenging.^3,4 Despite this, paramedics have an ethical duty to protect patient privacy to the greatest extent possible.² We see this in action when we try to protect patient privacy (and dignity) while attending cases in public spaces. Every paramedic working for a jurisdictional ambulance service will at some point hold a sheet up to block media cameras, tell a nosy bystander to keep walking and perhaps even tell a member of the public to stop filming a vulnerable person.

Given the conscientiousness of our profession in protecting privacy in these difficult circumstances, and at times, paramedics’ disdain for the actions of some members of the media, I am left perplexed. How is it that we, as a profession, seem to accept the presence of film crews whose presence is only possible by piggybacking off our professional standing in the community? I struggle to see how a news reporter’s camera is considered an intrusion of privacy, but somehow, it is different for our profession to invite a film crew into a patient’s home or other clinical engagement. Unlike other third parties, such as students or interprofessional teams, they play no role in the delivery of healthcare and provide no benefit to the therapeutic relationship – so why are they there?

I also have concerns that this may have very real and negative impacts on clinical outcomes or patient experience. Research in emergency departments has found that when patients believe their conversations can be overheard, some may change or withhold information from clinicians or decline aspects of a clinical examination.^5,6

This intersection of ethics and clinical safety is one of the core messages I try to communicate to my students when teaching the importance of ethical care – protecting the ethical delivery of healthcare improves both patient experience and clinical outcomes.⁷

The obvious rebuttal here, of course, is that patients can consent to the film crew being there.

This brings us to my second objection to ambulance reality TV shows: It remains my view that there can be no genuine consent for the presence of the film crew and any initial filming.

Consent to use footage isn’t the same as consent for filming in the first place

There appear to be different approaches to obtaining consent for filming, but neither resolves the underlying problem particularly well.

The first approach is a purely retrospective approach to consent. In this approach filming begins during the clinical encounter with minimal to no time spent obtaining consent to film – I have for instance heard rumours (although I should be clear I could not verify this) of an approach where paramedics were instructed to state something along the lines of “just ignore them [the film crew] for now, we can discuss them after” with little to no opportunity given for patients or loved ones to decline film crew presence. Regardless of how it is handled, this approach relies only on formal consent being sought afterwards before footage is broadcast.

The second approach, in my view, is no better and what I would call a faux-consent approach. This is where, upon arrival, a person is assigned to obtain a form of rapid consent for the film crew’s presence. This likely plays out as a paramedic or production member asking a patient or family member for “consent” as they walk in the door.

Although this problem is present in both approaches, the first approach most clearly highlights what I feel is the most overlooked issue with these shows: Consent to use footage after the event is not the same thing as consent to have been filmed in the first place.

By the time formal consent is obtained or withheld, the film crew has already been present and filmed what should have been expected to be a confidential clinical encounter. Later agreement to use that footage, given or not, cannot retrospectively provide consent for the circumstances in which it was originally filmed. What does it mean for our professional responsibilities to ensure consent and privacy in cases where consent is withheld after the filmed episode of care has already ended?

However, obtaining ‘consent’ at the door does not solve the problem either.

How can we be sure that the person consenting has had time to weigh up their options? Do they understand what is being consented to? Do they understand they have a choice? Do they understand (and believe) that if they say no, this won’t impact the quality of care they receive? Have they had enough time to consider the information given and ask questions?

All in the seconds provided to make that decision as paramedics walk in the door.  

Let’s return to our opening scenario briefly. Paramedics arrive during this urgent and stressful situation to assist your loved one and, as they enter, the second paramedic tells you that the film crew is with them and asks you something along the lines of, “Is that okay?”

Technically, the question has been asked, but do the circumstances allow for you to provide (or withhold) informed and voluntary consent?

I would say they do not.

There is little opportunity in that moment to consider what filming may involve, what might be recorded, who will see the footage, how it may ultimately be edited or used, or what refusing actually means. Most importantly, the request is being made alongside the arrival of healthcare that the patient has actively sought and may urgently need. The patient must immediately distinguish between the paramedics they are relying upon for care and the film crew arriving with them, understand that participation is optional, and feel sufficiently empowered to say no without any concern that doing so might affect their care.

Reasons in favour – education, public image and recruitment

There have been three reasons put forward to me as to why these shows are ‘justified’. Public education on when to call an ambulance, public image and encouragement of recruitment either into the profession or for an employer.

It is no secret that within countries with a mature and professionalised paramedicine discipline, there is strong competition for paramedic employment.⁸ Australia has, for several years now, had an oversupply of paramedicine graduates, with university courses in high demand and entry highly competitive. As for paramedicine’s general public image, I am yet to hear any good arguments as to why paramedicine, consistently one of the most trusted professions,⁹ requires any further publicity to improve its image or public standing.

Although, admittedly, I may have misunderstood the point here, and perhaps it is the ambulance services and health system leaders who feel they need some good PR.

Education is probably the strongest candidate here at face value, noting that I have previously addressed why education on ambulance use is a flawed concept if the intention is to reduce so-called inappropriate ambulance calls. Beyond “appropriate” use of ambulance, I have yet to hear a clear intended outcome for these TV shows as an educational resource. If anything, there have been concerns raised that these shows may be contributing to inaccurate perceptions among paramedic students and the public about the role of paramedicine in our health systems, through hyper-dramatic portrayals of ambulance work.¹⁰  

But even if any of these factors were needed, there remains a core issue: It is not our patients’ responsibility to provide either public education or professional publicity, especially at the expense of their privacy.

Final Thoughts and Comments

I have argued that consent for filming is not possible and that, without clear informed consent, the presence of a film crew in a healthcare setting is a breach of confidentiality and, most importantly, trust. I am not the first person to raise these issues; for instance, see also Eburn’s expert legal perspective. However, I would like to see more widespread consideration and discussion of our profession’s ethical and professional responsibilities regarding involvement in such shows.

Something that I would ask every healthcare professional and health leader to ponder is whether a person who calls an ambulance should ever have to consider the presence of a film crew as part of receiving healthcare. They did not invite a production company into their home. They called for a trusted health professional to help them in a time of need.

If you had to call 000 this evening, would you be okay with a film crew attending?

I certainly wouldn’t.

As always, stay curious and be excellent to each other.

References

Show References (10)

1.            11 Ambulance services – Report on Government Services 2026 [Internet]. Available from: https://www.pc.gov.au/ongoing/report-on-government-services/health/ambulance-services/

2.            The Australian Health Practitioner Regulation Agency. Code of Conduct [Internet]. 2022. Available from: https://www.ahpra.gov.au/documents/default.aspx?record=WD22/31749&dbid=AP&chksum=p10Wc2v5MWiwLsVtkgFXYw%3d%3d

3.            Koskimies E, Koskinen S, Leino-Kilpi H, Suhonen R. The informational privacy of patients in prehospital emergency care—Integrative literature review. J Clin Nurs. 2020;29(23–24):4440–53. https://doi.org/10.1111/jocn.15481

4.            Torabi M, Borhani F, Abbaszadeh A, Atashzadeh-Shoorideh F. Ethical decision-making based on field assessment: The experiences of prehospital personnel. Nurs Ethics. 2019 Jun;26(4):1075–86. https://doi.org/10.1177/0969733017736925

5.            Karro J, Dent AW, Farish S. Patient perceptions of privacy infringements in an emergency department. Emerg Med Australas. 2005;17(2):117–23. https://doi.org/10.1111/j.1742-6723.2005.00702.x

6.            Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022 Jan;38(2):351–5. https://doi.org/10.12669/pjms.38.ICON-2022.5785

7.            Stolt M, Leino-Kilpi H, Ruokonen M, Repo H, Suhonen R. Ethics interventions for healthcare professionals and students: A systematic review. Nurs Ethics. 2018 Mar;25(2):133–52. https://doi.org/10.1177/0969733017700237

8.            Sinclair L, Stewart S, Devenish S. Exploring the Experiences of Australian Graduate Paramedics: Transitioning Beyond Government Ambulance Services. Int J Paramed. 2025 Oct 8;(12):31–43. https://doi.org/10.56068/NCYL3541

9.            Reader’s Digest Editors. The most trusted professions in Australia | Reader’s Digest Australia [Internet]. n.d. Available from: https://www.readersdigest.com.au/true-stories-lifestyle/work/the-most-trusted-professions-in-australia

10.         Johnston T, Cameron C, Batt AM. Portrayals of a profession: Reflecting on media depictions of paramedics. Paramedicine. 2024 May;21(3):89–93. https://doi.org/10.1177/27536386241244786

Note on Table/ Plot Data Sources: Primary sources for the table and plot were publicly avaliable broadcaster, production-company and archival records, particularly Screen Australia, NZ On Air and Ngā Taonga Sound & Vision, supplemented by TVDB where needed to verify season counts and original broadcast years.