INTERNATIONAL LIFE SAVING FEDERATION
Gemeenteplein 26 – 3010 Leuven – Belgium
Tel: +32/16896060 - Email: ils.hq@telenet.be - Web: www.ilsf.org

ILS POLICY – POL 03
LIFESAVING AND ETHICSThis Policy covers principles and issues which influence and direct all who identify with the profession
and vocation of lifesaving and lifeguarding and its training as Personal, Organisational and National
Members of the International Life Saving Federation (ILS).
INTRODUCTION
The ILS has, as its core principle, the saving of life in the water environment. Such a fundamental ethic
embodies all that is highest in human endeavour: the preservation of life, the protection of the vulnerable
and helpless, and the reduction of injury and distress.
Embodied within this core task is a diverse array of themes such as volunteering, training, policy
development, harm reduction, the implementation of safety legislation and the allocation of often scarce
resources - to name but a few of the challenges which confront those who endeavour to save life. All
who are a part of the discipline and profession of lifesaving know that these themes, in turn, involve
judgements which relate to such diverse issues as equality of opportunity, the implementation of rules
and regulations which restrict personal freedom, the promotion and reward of personal altruism andcourage, and questions of research integrity 1,2. In particular, the underlying core value which underpins
all of lifesaving - that of service-beyond-self - has great ethical challenges when extended beyond anyof us as individuals, and when such service is demanded from others.
All these themes have one component - that of ethics. The ILS has, as one of its essential values, acommitment to best-practice ethics in every aspect of its “up-front” or “close and personal” role of saving
and resuscitating potential victims in the water environment, and in every aspect of its governance andadministration. Such principles involve all individuals who are members of the ILS and its various bodies
and institutions; and by extension to all national bodies who are members of the ILS itself.
THE PRINCIPLES OF ETHICS
Ethics comprise those themes which enable people “to do the right thing”. Ethics embodies thosethoughts and actions which the ILS considers “as our duty”, or “as our conscience dictates”.
Most Federations/Organisations, and the individuals of which they are composed, would wish to makedecisions, choose paths or treat others “in the right way”, by “doing the right thing”. Each of us brings
to lifesaving our own individual moral codes, our personal religious or philosophical backgrounds, ourlife’s experiences and the competing demands of the challenges of the moment. Every individual has
their own personal moral code, and such would influence the way they would behave, even if they lived
alone and by themselves as the sole occupant of a desert island. Ethics is that subject where thesequestions of “What is the right thing?” involves others. In that the ILS is composed of many individuals
with the most diverse array of personal religious, moral and experiential backgrounds, it is desirable
that one looks at, explores and perhaps affirms the ethical principles which involve us all. Corporations,societies and individuals are constantly confronted by the need to make decisions in the face ofcompeting options. One influence, in choosing a decision from two or more possible options, is thisimperative “to do the right thing”.
Because different individuals and groups may have different ideas and opinions about what is “right” or“correct”, a brief review of the subject of ethics may be helpful. One basic and inescapable theme in theentire discipline of ethics is that there are always honestly-held differences of opinion on many questions

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which confront us as members of groups. Differences of opinion are the norm on many of these issues,
not the exception 3. If there were no differences of opinion, we would simply have rules which the clear
majority have come to regard as self-evident and there is no need or issue for any ethical debate.
Almost all agree that torture or murder of children is wrong, and most nations simply have laws to outlaw
such and there is very little need for ethical debate. Differing opinions about what is “right” means thatthe subject is never simple. However, most corporations, associations and societies - as well as
individuals - agree on certain basic principles which influence how we make decisions and conduct both
our personal and corporate lives.
There are at least seven such principles which comprise the subject of ethics today:
1.
2.
3.
4.
5.
6.
7.

Autonomy - total personal control over what is done to one’s body; and similar affording of such
autonomy to the bodies of others.
Beneficence - one should act in a way which will bring only good to others.
Non-maleficence - at the very least, one should “do no harm”.
Justice - fairness with respect to both individuals and the groups which they comprise. Risks, aswell as benefits, should be shared equally by all stakeholders in a system.
Context - ethical decisions are context-specific; and what is “right” in one context, may notnecessarily be agreed to be the best ethical path in different circumstances.
Responsibility - the acceptance that one is responsible for one’s actions, both at the personal aswell as the corporate or societal level.
Systems of Governance - if one voluntarily accepts a system of governance, e.g. democracy,
then one aspires to abide by that system; when changes or modifications are needed, one uses
internally-consistent rules of the prevailing system of governance to effect changes.

The first five of these universally accepted Principles of Ethics are sometimes called the BeauchampChildress Principles, after the two ethicists who first formalised these principles 4.
None of these principles is necessarily absolute; and each depends on the context in which decisions
are being made or judged. These principles are important in the profession and vocation of lifesaving,and in its governance.
One fundamental principle in ethics, indeed the very core of lifesaving, is that of beneficence. This
theme refers primarily to the endpoint of the saving life itself. However, how such lifesaving is achieved- training, the avocation for and allocation of resources, the promotion of diligence in surveillance,
perhaps even courage itself - all these themes may not be beneficent to all stakeholders in theprofession of lifesaving. A brave lifesaver who loses his or her life in a rescue attempt, and by whose
action his or her family is left destitute, has left a conflicting legacy of both good and ill. An individual
who saves a sane but determinedly suicidal person from drowning, is denying that person the autonomyof their own personal decisions. Those who concentrate on the teaching of cardiopulmonary
resuscitation (CPR) on younger volunteers may be unfair to the aged, whose spouses and partners andfriends may have the greatest need of all for the results of such training - that is, the principle of justice
is compromised in that one may be promoting a system of inequality of potential salvage.
Most individual and corporate decisions in real life are neither difficult nor contentious in the ethicalsense. For most, what is the “right” thing to do is obvious to caring and responsible decision-makers.
Nevertheless, the ILS wishes all its members to be aware of these issues; and to maintain the highest
ethical principles which underpin our actions, our decision-making and our collective governance.

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FREE-WILL
Ethical themes involved in lifesaving, and training for an individual to save life, rest essentially on theassumption that a lifesaver has free will. In other words, when confronted with a drowning victim, aperson on the spot has to decide (a) whether it is desirable to attempt a rescue or resuscitation; and (b)if so, whether to put himself or herself in danger in the attempt. Each of these two questions has in turntwo possible answers - thus making four decision-doublet pathways possible.
Imagine a lifesaver or bystander witnessing an individual performing yet another in a series of multiple
suicide attempts, determinedly and in full possession of their faculties. A potential lifesaver thus has toanswer the first of these two issues - “Whether it is desirable to attempt a rescue or not?” In most cases
the answer will be “Yes”, although the question is a legitimate one and a very real one often for those
who know the potential victim well. A similar issue arises in those who persistently and knowingly put
themselves in danger and then find themselves in a potential drowning scenario. Examples of thoseindividuals who persistently and wilfully swim “outside the flags” on beaches which are patrolled bylifesavers. Again, when such individuals have knowingly, deliberately and often repeatedly put
themselves in mortal risk, find themselves in danger, a potential lifesaver has to ask the question “Shall
I attempt a rescue?”. Again, the altruism and traditions of our profession are such that the answer isalmost always “Yes” - but again the question is a real one and always engenders great frustration andoften heartache. Lifesavers or bystanders may know that to attempt the potential rescue of a drowningsubject on the one hand, or to “leave be” on the other, in turn involves them, rather than the victim, inseparate type of risks. Sometimes these risks may be the potential threat of legal action if a decision
not to attempt a rescue, was deemed to be the correct one under the circumstances.
Consider a different scenario, that where one’s own child is drowning before one’s eyes. Almost
everyone would answer the first of these two questions - “Is a rescue desirable?” - instinctively in theaffirmative. This being the case, it is the second of the above two questions which is the only one whichconfronts such a potential rescuer. That question is, “What degree of risk should I chance to save mychild?”. Almost all parents would risk their own life under such circumstances, but again it is essential
to see the importance of this question. If such a parent perceived the risk of such an attempted rescue
to approach 100%, then there is no benefit either to the drowning child or to his other brothers or sisters
who might be left without a parent who inevitably died if they attempted a rescue in the face of suchodds.
Decisions of these kinds - “Do I to attempt a rescue?” - presuppose that an individual has free-will. Mostof us live our lives as if we have free-will in the majority of decisions which confront us. However, it mustbe said that there is a philosophy that denies the reality of free-will. This philosophy says that each of
us is so programmed by our individual genes, by our upbringing and by our life’s personal experiences,that we will act in a predetermined way in any situation which confronts us. Those who hold this view
feel that the question “Do I to attempt a rescue?” is not a real question in that a lifesaver’s decision isfixed by his or her prior experiences; and that the illusion of free choice is not valid.
Although this theme is of great interest to philosophers and theologians, the pragmatics of lifesaving
are such that we must function as if we have free-will. With this assumption inevitably comes
responsibility. In other words, if one accepts what to many of us regard as self-evident, that we havefree-will, we are then exposed to the ethical, indeed sometimes the personal moral responsibility of ouractions; whether these situations occur on the beach or beside a swimming pool, or in the committee
rooms of corporate governance of the National Federation/Organisation or the ILS.
EMPOWERMENTOne of the basic principles of ethics is that of autonomy. This implies not only free-will for oneself, butboth the acknowledgement of the provision of independence to others. Such autonomy only has reality
if one has choice. If one has choices one is empowered and autonomy is real.
An individual has a choice to attempt to rescue, or commence CPR, if he or she is trained in suchtechniques. Without such training a choice is still possible, but with respect to an effective outcome - a
successful save followed by a successful resuscitation, or both - this choice may be spurious. Certainly,
if one is trained in lifesaving techniques and in the drills and skills of CPR, one is (a) better skilled toInternational Life Saving FederationILS Policy - POL-03. Lifesaving and Ethics

Page 4know what the real choices are and what their significance means; and (b) one is informed about thehands-on skills needed to effect a rescue or resuscitation, should one’s decision be to so proceed.
This is the phenomenon of empowerment. In other words, lifesaving training empowers the individualin arming him or her with choices, often in that most significant of all life events, the potential saving oflife. Perhaps more than in any other real-life situation, this empowering of potential rescuers is a meeting
place of the principles of ethics and the pragmatics of survival itself.
Almost all bodies, including the ILS, which teach lifesaving and resuscitation skills, do not prescribe
how an individual with act in any specific drowning scenario which might confront them. In other words,
the aim of training is to empower individuals to have a real choice when confronted by a drowning victim.
Everyone will assess the situation, decide whether a rescue-resuscitation is desirable and then assess
the risk to themselves and others. Such action will inevitably be the subject of ethical assessment by
one’s peers.
If a bystander, who is at no risk to himself, elects not to help in a drowning scenario, such a person will
be exercising their free-will but will inescapably be ethically condemned by those who feel that “heshould not have walked by on the other side”. Alternatively, peers will regard as a hero one who has
risked his or her own life to save a drowning victim. In some cases, however, if a potential rescuer
decides not to attempt a rescue because the risk is too great, and if this opinion is subsequently
accepted by all informed peers, then there will accrue no ethical or moral condemnation for the
bystander’s decision.
These ethical themes apply particularly to the principles of training for rescue and resuscitation. The
issue is the same in principle, but different in degree and practice, in the situation where a lifesaver isproviding a custodial or protective service for potential victims. Here there is an implicit moral contract
and often an explicit legal obligation, that the lifeguard-on-duty has an obligation “to guard and to keepsafe”. Under these circumstances the lifesaver or lifeguard has exercised free-will in volunteering orcontracting to provide the lifeguard service; and has empowered themselves to have choices in any
conceivable drowning circumstances, by their prior training and experience.
THE LIMITS OF OBLIGATION
Ethicists and philosophers acknowledge that decisions and actions in our daily lives may be classified
into three types 5:
1.

2.

3.

Many decisions or actions which confront us involve no moral or ethical questions at all.
Fortunately, most of the decisions we make in our working day fall within what are called the“sphere of permissible free personal choice. These decisions or actions are called Acts of moral
indifference.
By contrast, there exist a whole group of actions which we know in our conscience to be required,to be obligatory, or to be ones which we are duty-bound to perform. These are also actions which
we would be morally blameworthy if we did not perform them. These are termed Acts of moralerequirement.
There is a third class of action which is admirable and virtuous to do, but whose omission cannot
lead to any reasonable blame. These are heroic actions, or are those which everyone would regard
as “beyond the call of duty”. They are called Acts of supererogation.

Lifesaving occupies a special place in this scheme of actions. The underlying ethos of lifesaving istraining to save life if it is threatened in the water; and specially to prevent the risk of drowning fromoccurring in the first place. As citizens of water-oriented societies, many believe that everyone shouldbe trained in the basic drills and skills of water safety and those of CPR. In this sense, basic training in
simple rescue and resuscitation techniques is non-discretionary for any moral person; and thus, thevery fundamental theme of all our lifesaving activities, particularly those of training, comes into thepurview of “Acts of Moral Requirement”.
Such preparedness for the unexpected - a part of every lifesaver’s training - is logically distinct from thesituation where a bystander or observer is unexpectedly confronted with a drowning victim. Here there
is a range of risk involved, a spectrum of threat which may range from trivial to mortal. Here, theInternational Life Saving FederationILS Policy - POL-03. Lifesaving and Ethics

Page 5observer - whether trained in rescue and resuscitation or not - has to decide. He or she is supposed tohelp, but at some point, along the scale of risk or threat to the would-be lifesaver, no-one will criticise
or morally condemn such a bystander or lifesaver if he or she does not put themselves in severe harmsway to attempt a rescue. This then is the challenge to perform an Act of Supererogation. Some, whenconfronted with such a drowning scenario which will expose a potential rescuer to grave risk, will attempta rescue. Rightly, he or she will be regarded as a hero, whether alive or dead following the attempt.
Another individual may not have the will or the courage to act in such circumstances; and they will in
no way be condemned for such inaction. Supererogation applauds heroic action but does not condemn
an individual who declines to put themselves at serious risk.
It is a basic theme of all lifesaving training that one establishes systems in which acts of supererogation
are not required. That is, by introducing preventive and safety practices, that the threat to and loss oflife in the water will not occur in the first place; and if it does, that rescue and resuscitation techniques
will be such that all will both volunteer and have the skills to respond as an Act of Moral Requirement.
Under these ideal and utopian circumstances, real-life acts of supererogation - life-threatening rescues- will not be needed.
In practice, the essence of lifesaving is to promote the ethos of the Good Samaritan 6. However, goodSamaritanism is sometimes risky - not least in some situations in the legal sense. To achieve a desirable
society in which the Good Samaritan can act, and be applauded for such actions, one needs to reduce
the risks of being called upon to act “beyond the call of duty”. Training, a knowledge of strengths andlimitations, practice with different simulated drowning scenarios - all will reduce such risks to future
Good Samaritans who are confronted by the unfolding of a drowning incident before their eyes.
The ethicist, Judith Jarvis Thomson, makes a distinction between “Good Samaritans” and “Minimally
Decent Samaritans” 7. Although no-one is obligated to make a life-threatening sacrifice that would be in
the very best of the Good Samaritan tradition, all in enlightened societies are required to be “Minimally
Decent Samaritans”. This is the fundamental ethical principle of lifesaving and of drowning prevention
and water safety - that as “Minimally Decent Samaritans” we can (a) courageously work to provide asafe water environment; and (b) if we are confronted with a drowning scenario, to act skilfully andefficiently.
Some, heroes, will go further, undertaking courageous acts which will save life. They are to beapplauded; but all would wish to help generate water environments and societal attitudes where theneed for such action is reduced.
There are several other issues which may confront lifesavers, potentially, in the line of their self-imposed
duties. One such are the effect of “do not resuscitate” orders. Such take the form of Living Wills, orAdvance Directives, which document in formal terms that an individual is not to be resuscitated should
they be found in a situation where cardiopulmonary resuscitation is needed. Such are important issues
within hospitals and especially within homes for the aged care. In the practical context, they are not an
issue for lifesavers, either as matters of training or as matters of duty for lifeguards, usually on the beachor at the poolside. If resuscitation is needed for a non-immersion collapse in the water environment, it
is essential to commence CPR in the normal way without wasting time looking for such Living Wills
which may be carried on the person or held in an individual’s wallet. Once resuscitation is started, is
may well be a consequential decision for professional paramedics or physicians in the Emergency
Room to investigate such Orders and make judgements about them.
An important issue during cardiopulmonary resuscitation, in the water environment, is not to give
estimates of likely outcome to relatives or other bystanders. This is best left for medical personnel
managing such a resuscitated person in the Emergency Room of the hospital to whom the victim istransported. Opinions or estimates about likely outcome are at best impractical or at worst dangerous,in the context of the dramatic events which surround a rescue from the water and subsequent CPR if
such is undertaken. The most comfort will be given to relatives and bystanders if they see professional
lifesavers discharging their self-imposed rescue and resuscitation efforts undertaken with obvious
confidence and skill. Favourable but incorrect estimates of outcome given in an humanitarian attempt
to offer short-term comfort, is never such in longer-term perspective - if it is wrong. An incorrect gloomy
prognostication, under similar circumstances, causes needless distress if in fact the victim makes aInternational Life Saving FederationILS Policy - POL-03. Lifesaving and Ethics

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good recovery. In other words, the ethical limits of obligation under such circumstances are to workwithin the domain of one’s training and experience and to be aware of the need for restraint in this area.
Another issue which is of both ethical and pragmatic concern to relatives and bystanders, is whether
they should be allowed to remain as witnesses of the resuscitation attempts of a victim rescued fromeither a fresh water or saltwater immersion.
Such situations have to be judged on their merits in their infinite variation and in their infinite range ofdifferent circumstances. With respect to children, however, studies have shown that most parents dowant to be present during an attempted cardiopulmonary resuscitation of their child, if such is being
performed with manifest skill and expertise 8.
Questions of “When to stop cardiopulmonary resuscitation?” are often asked by those in training forlifesaving and cardiopulmonary resuscitation skills. In general, cardiopulmonary resuscitation should becontinued for as long as one can physically continue, or until a decision is made by a physician thatfurther attempts are futile. From a technical point of view, it must always be remembered that in apulseless apparently dead person, it is wrong to abandon attempts if (a) hypothermia or (b) drug
overdose is a possibility. In almost all cases, the limits of obligation of a lifesaver involved in aresuscitation continue until they transfer both the technical as well as the ethical obligation ofmanagement, to the next person in the “chain of survival”.
ETHICS OF GOVERNANCE
The ILS follows the normal best-practice ethics of governance and of administration. As a world body,the ILS has established, as its basis of governance, input from all Member Federations/Organisations.
Under such circumstances, administration has to be vested in an Executive, responsible at its discretionfor short-term or tactical executive decisions; but to be both responsive and responsible to the federated
world body for strategic direction and for policy decisions.
The ILS affirms the principles of gender equality of opportunity for all. It affirms the special duty-of-carewhich all adults afford to young people, especially children. The ILS specifically affirms that it has a“zero tolerance” policy on issues such as sexual abuse of the young and of those in positions ofinequality in any of the ILS’s national or international systems of governance and of those bodies which
comprise it. Naturally this applies also to all individuals in training, to those in junior positions withinhierarchies and of course to those victims of immersion incidents.
Some Member bodies of the ILS have formal Codes of Conduct, demanding adherence to issues suchas gender equality, the proscription of sexual harassment and an affirmation of equality of access andopportunity irrespective of age, gender, sexual orientation or disability.
The ILS also acknowledges the special protection needed for whistle-blowers in times of perceived
aggrievement; and the efficient management of personal aggrievement and complaints, within the rules
and constitution of the ILS’s Member Bodies. In the context of governance, and superimposed upon theimportant background of “caritas for one’s own”, it is very important indeed to be aware that every
attempted rescue and resuscitation involves not only a victim, but also a lifesaver. In this context,
governance extends to a duty of care to those who are involved, in real-life, not only in a successful“save”, but also in an unsuccessful rescue or unsuccessful attempted resuscitation. Many of ourcolleagues feel, illogically but intensely, that they have failed under such circumstances - of not always
achieving a successful resuscitation; and some embark on self-recrimination. Others feel guilty. Helping
such individuals may be as important as helping those who are in distress in the water. The fundamental
principle here is that the great traditions of lifesaving, embodied in our ethics of governance, extend not
only to potential victims whose lives we endeavour to save, but apply also at a very personal level tothose who are so governed.
CONCLUSION
Most lifesavers do not treat their vocation simply as another hobby or pastime; but believe that what
they do has special significance in the community. Most lifesavers delight in the water environment,
whether this be the crashing surf of the open beach, the estuary or bay with its water and water-life; orInternational Life Saving FederationILS Policy - POL-03. Lifesaving and Ethics

Page 7the pool with its social life of laughter and sporting competition, mixed. Their love of the water and its
world does not simply constitute a physical scenario for the potential rescues and resuscitation which
they perform - it transforms that altruism to something very special, even grand. Lifesavers come fromall walks of life and from many personal moralities and philosophies. For these reasons, different beliefs
about many of the ethical questions inherent in lifesaving cannot be formalised as rules, by any
committee. Rather, lifesaving ethics are themes of discovery, and of personal exploration.
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6.
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Beauchamp TL, Childress JF. Principles of Biomedical Ethics. Third Edition. New York, Oxford University Press, 1989.
Fishkin James S. “Three Kinds of Acts”. In: The Limits of Obligation. New Haven (USA), Yale University Press, 1982.
Chapter 2: 10-13.
Pearn J. St. John and St. Luke. The Foundation and Influence of the Good Samaritan in contemporary Australian life. J.
St John Amb Aust Hist Soc [ISBN 1445 7490]; 2003; 3: 23-25 (by invitation).
Thomson, Judith Jarvis. “A Defense of Abortion”. In: The Rights and Wrongs of Abortion. Eds. Marshall Cohen, Thomas
Nagel and Thomas Scanlon. Princeton, Princeton University Press, 1974: 3-22. [esp. p. 19].
Boie ET, Moore GP, Brummett C, Nelson DR. Do parents want to be present during invasive procedures performed on
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Policy approved by the ILS Board of Directors on 19/09/2006, on 03/09/2016, on 07/10/2019 and on 24/09/2022.