You are required to submit a 2000 (/+10%) word essay focusing upon a provided patient case study that explores autonomous practice relative to evidencebased guidelines and the ethical practice of a paramedic. This must relate to learning outcome 2; identify and discuss the legal and ethical principles of autonomy and accountability in relation to paramedic practice. Case Outline: you are called as a second crew to a male patient, approx. 70yrs of age in cardiac arrest. There is a solo paramedic responder in attendance. When you arrive you note that the paramedic on scene is not performing CPR, only the 4 lead ECG wires are on the patient (not defib pads) and the monitor not turned on. The patient is peripherally cyanosed. You and your crewmate start resuscitation – defib attached showing VF. Following a period of resuscitation the decision is taken to ROLE. During the debrief the solo paramedic responder questions your actions to commence CPR and rhythm changes (VF – VT – pulse – VT – VF and ROLE). You ask him about his decision to only administer 2x 1:10,000 adrenaline 1mg throughout 30mins of resuscitation. He responds saying that he is an autonomous practitioner and therefore able to make such decisions based on his knowledge of the evidence. The case study is adapted from a publically accessible HCPTS fitness to practice hearing. Please discuss your understanding of the case based on the ethical considerations of the actions of all and your knowledge and understanding of the autonomous practitioner in relation to a HCPC registered paramedic. Please support your answer and discussion with appropriate evidence. The actual case referred to is that of Mr Laurence P Milton, available in the HCPC website.