Step up for our paramedics!

People seem to help less when surrounded by others. Scientist found ways to decrease this effect, one of the ways to get people to help is to address them personally. It’s important that we bother because paramedics will fail to accomplish their goal, saving lives, if we allow this aggression to continue.

Nobody acted when 79 percent of the paramedics working in the Netherlands faced physical and verbal aggression, threats, and intimidation. This appears from the report written in 2011 by the DSP-group (a research company in the Netherlands), who interviewed 272 paramedics. SIRE, a company that denounces social problems, started a campaign to stop the violence. This campaign was successful in creating awareness with 9 out of 10 people hearing of the campaign and over 93.000 people signing the petition on their website. However, there are still lots of reports of violence against paramedics coming in at this moment. It looks like signing this petition doesn’t make people taking action. So although people show that they care, they don’t seem to do anything in the face of real-life aggression. Are these people too lazy to stand up and do something? Probably not, and I will explain their lack of helping behavior by using science. 

How many paramedics are attacked?
The government sounded the alarm bells about the, according to them, expanding problem. How is it possible than that the report by the DSP Group reported a decrease in the number of violent cases from 2009 till 2011? Is the government simply trying to scare us to death? Let´s look at what the director of the paramedics in safety region Noord- Holland Noord, Martin Smeekes says:

” It would be an illusion to think that the violence against our  paramedics is decreasing. Paramedics are less likely to report violence because they get used to being called names when they’re trying to do their job.'”

So can we assume that there really is a problem? If we check Martin Smeekes assumption in the DSP report, we can see indeed that only 29 percent reports a case to their manager and only 11 percent reports it to the police. These figures confirm the statements by Martin Smeekes, paramedics do seem to report just a small part of the experienced violence and it looks like they really get used to being attacked. Do we have to allow these jerks to interfere our paramedics who are trying to save lives?

Why are people reluctant to help?
If we look at cases in which a paramedic was attacked, one thing stands out: The attack is surrounded by other people most times. This is not surprising when you consider that the work field of the paramedics takes place in residential most of the time. How can we explain so many people opposing against violence with nobody stepping up? We can find an answer in science by studying the bystander effect proposed by Darley and Latané [i]. The bystander effect refers to the phenomenon that when more bystanders are present, people are less likely to provide help. At least 105 independent studies confirmed Darley and Latane’s expectation: The more bystanders were around, the less likely people are to provide help [iii]. So it’s easy to make the connection to our paramedics:  Nobody helps when our heroes are needlessly attacked even when surrounded by dozens of bystanders.

How can we explain the individuals say that they’re fed up with these jerks, but that they just stare and do nothing when placed in a group? The most important reason why this happens is because of diffusion of responsibility [i]. When an accident happens right in front of you and nobody is around, you’ll probably feel responsible for taking action. Responsibility is shared among people when more bystanders are around. This effect is also observed in lab experiments. Study participants were placed in individual cubicles and told them that they could communicate with the other subjects over an intercom system. There was actually only one real participant in de study, the other participants were prerecorded voices, including one person that had a seizure. The researchers manipulated the size of the discussion groups; the discussion groups consisted of either two persons (the participant and the ‘victim’), three persons (the participant, the ‘victim’ and one perceived bystander), or six persons (the participant, the ‘victim’ and four perceived bystanders). After a few minutes of discussion, the subject heard through the intercom that the other subject was having an epileptic seizure. Point of the study was to see whether the real participant would attempt to help the victim. In the first group 85 % was helping, in the second group 62 %, and in the group with six people only 31 % was acting. Darley and Latané irevealed with this experiment that an individual’s likelihood to help is decreased when more people are around. As a result, no one will help and we just allow these jerks to attack our paramedics.

How can we get people to help?
So how can we get people facing violent use against a paramedic to step out of the crowd and do something? We have to take a look at the process in the mind of bystanders at the moment of an attack. The first step in this process is labeling the situation as an emergency. It sounds strange but in reality emergency situations are often ambiguous [iv]. Imagine yourself walking through the centre of your hometown and seeing a group of people standing around a paramedic and a hostile man. It looks like he is hitting the paramedic, what happened here? You may think that the paramedic hit the man first, or maybe you’ll even think that the paramedic deserves to be attacked. You’ll notice that none of the other people seem to bother. When you’re unsure about what’s going, you won’t be very likely to help as well. Most times we don’t really know what’s happening, and we use other people’s behavior as a source of information. Since most of them don’t know what to do as well, everyone will just keep on staring like a group of robots [iv].

Is it possible getting people to act like individuals instead of just following the herd? We can start by making situations more clearly; the can do this by screaming out loud that there’s a real emergency going on. It’s important to point your scream for help to one specific person. Scientist found that people will feel more responsible when addressed personally; ‘hey you with that blue shirt!’ These findings can help paramedics when they’re attacked in the middle of a group of staring people [v].

Another way in which you can overcome the bystander effect as a bystander is by learning more about the bystander effect and diffusion of responsibility. Scientist found that students who learned about the bystander effect in a lecture were more likely to intervene in a bystander emergency [vi]. This experiment reveals that having knowledge about the effect helps people to really do something instead of just staring like a robot.

So we should not stop by just signing a petition. We have to focus on the big influence that a group has on our behavior. It’s possible to step out of the group of staring robots if you learn more about the bystander effect and tell your friends about it as well. Although two named in this blog, there are many ways to reverse the bystander effect. If you want to know more you can also read this blog. Together it’s possible to make the important job of our paramedics a little bit easier. They will be able to accomplish their jobs again; saving lives.

Written by: Janneke Schilder

Suggested readings:
Meta-analysis: Fischer and colleagues
Teaching pays:Beaman, Barnes, Klentz, and McQuirk


[i] Darley, J.M., & Latané, B. (1968). Bystander intervention in emergencies: Diffusion of responsibility. Journal of Personality and Social Psychology, 8, 377–383.

[ii] Darley, J.M., & Latané, B. (1968). Bystander intervention in emergencies: Diffusion of responsibility. Journal of Personality and Social Psychology, 8, 377–383.

Latané, B., & Darley, J. M. (1970). The unresponsive bystander: Why doesn’t he help? New York: Appleton-Century-Croft.

[iii] Fischer, P. et al., (2011). The bystander-effect: A meta-analytic review on bystander intervention in dangerous and non-dangerous emergencies. Psychological bulletin, 4, 517-537.

[iv] Aronson,E., & Akert, R.M. (2007). Social psychology. London: Pearson.

[v] Markey, P.M. (2000). Bystander intervention in computer-mediated communication. Computers in human behavior, 2, 183-188.

Shaffer, D.R., Rogel, M., & Hendrick, C. (1975). Intervention in the library: The effect of increased responsibility on bystanders’ willingness to prevent theft. Journal of applied social psychology, 5, 303–319.

[vi] Beaman, A., Barnes, P. J., Klentz, B., & McQuirk, B. (1978). Increasing helping rates through information dissemination: Teaching pays. Personality and Social Psychology bulletin,4, 406–411.


8 thoughts on “Step up for our paramedics!

  1. Mathijs

    Hi BQSUVT,

    Interesting discussion! Good that you shed some light on this discourse, it is such a pity that this kind of violance happens! Your dissertation about overcoming the bystander effect brings forward some interesting ideas. I understand that educating bystanders about the bystander effect might work. However, my quesiton is how to reach these bystanders (hence the entire polutation). And maybe even more important, how do you think you can make bystanders want to learn about the bystander effect? The SIRE advertisements might help but probably more efforts are necessary! Do you think about certain courses at (high)schools, work- and public places etc? Maybe short (electronic) presentations in train and busses might work; most travellers have then the time to listen to your story.

    Ciao Mathijs

    1. jdschilder

      Hi Mathijs, Thanks for your interesting comment. I think that it is a very good idea to provide information about the bystander effect in schools. This way, the bystander effect will become common knowledge and hereby decrease the bystander effect, according to Beaman and colleagues (1978). As we agree, the SIRE advertisement are not enough, but it might be interesting to see what happens if you provide information about the bystander effect in these commercials. This will probably reach more target groups as people travelling by train is just a specific target group. It would be very useful to study this. As SIRE reaches a large amount of people, knowledge about the bystander effect will be spread on a large scale.

  2. hanna wimmenhove

    This is such an interesting topic! It intrigues me why people don’t help, while they can see that nobody else is helping. I understand the theory of the bystander effect and the concept of diffusion of responsibility. Only when something is happening and you can see that nobody is helping, it looks very strange to me that you aren’t addressed on your feelings of responsibility.
    And I do think that there’s something to do about the persons who use violence against paramedics. For example there can be special programmes at school for kids who have higher chance of getting into delinquent behavior. What do you think of such programmes?



    1. jdschilder

      Hi Hanna,

      thank you for commenting on my blog. People usually find it hard to understand why bystanders don’t help. However, as mentioned in the article, at least 105 studies confirmed the same effect (Fischer et al., 2011). Although we can’t believe that we will be influenced by other people around us, most of us will probably be one of these staring people as well.

      I think that you are making a good point when you say that we have to focus on the aggressors as well. If you want to start programs for kids with a higher chance of getting into delinquent behavior, what kind of characteristics would you look for?

      I still think that it will cost a lot of effort to do so and it might be easier and more effective if we will teach this children about the bystander effect and hereby increase their awareness of the problem.

  3. Kees

    This discussion is a difficult one. Information in educational schoolprograms and campaigns as SIRE did, are usefull for sure. Specialy using testemonials of victims has an great impact and can help redusing the bystander effect.
    The people dat becomes violant is a problem more difficult to solve. Most of them are unther the influence of alcohol or drugs what makes them erratic. Next day most of them wil say sorry but that doesn’t increase the problem.
    Maybe naming and shaming will help. The fact that family, friends but also your employer is prompt on your misbehaviour can be a reasen for potential jerks to bind.
    But i am afraid that as long as the problem with excessive use of alcohol and drugs is not solved this problem also persists.

    1. jdschilder

      Hi Kees, you emphasize a very important issue; how can we stop these aggressive people to use aggression in the first place.

      I agree with you that it makes it extra difficult when drugs and alcohol are involved. Although I agree with you that these people have to be punished, this doesn’t seem to solve the problem. This can also be explained with science; positive reinforcement is a better way to increase wanted behavior than punishment. Reinforcing behavior (e.g. focusing on helping) tells people what to do, whereas a focus on negative components doesn’t provide information about what one should do (Gazanniga & Heatherton, 2005).

      It would be interesting to study whether education about helping behavior will not only increase helping behavior, but if it makes people less likely to use violence as well. This way we will prevent people from using violence behavior, and if people still use violence (as I agree with you that this problem will persist when people are under influence of alcohol and drugs) we can get people to help the paramedics when they know of the bystander effect.

      Gazanniga, M.S. & Heatherton, T.F. (2005). Psychological science. New York: Norton & Company.

  4. Mark

    It seems like these situations differ from the research you described. In the research there isn’t any danger in trying to help; however, in the paramedic situation people who help could find themselves in a dangerous situation. Helping in these situations is potentially quite costly and I’m not convinced that educating the public about the bystander effect will reduce these costs.

    1. jdschilder

      Hi Mark, thanks for responding to my blog.
      Your argument is supported by a study by Schwartz and Gottlieb (1976) who found no bystander effect in dangerous situations. However, this was only found when evaluation apprehension was present, so if people knew that others evaluated them they were willing to help in order to become a hero. Hence, we could use these results to get people to help in dangerous situations by raising evaluation apprehension. As the bystander effect and the importance of helping behavior becomes common knowledge, this might increase the perceived evaluation apprehension and hereby helping behavior.
      Van Bommel and colleagues (2012) also found the important effect of the perceived evaluation apprehension. This study revealed that the bystander effect can be reduced by creating public self-awareness via accountability cues, in this case the use of cameras. Hence, the perceived evaluation apprehension seems to get people to help especially in dangerous situations. There for I believe that the bystander effect is present in dangerous situations, and that bystanders in dangerous situations are not per definition reluctant to help. Finally I would like to add that people who face a violent attack against a paramedic don´t have to risk their own health. Helping behavior can also be defined as reporting the attack to the police.

      Schwartz, S., & Gottlieb, A. (1976). Bystander reactions to a violent theft: Crime in
      Jerusalem. Journal of Personality and Social Psychology, 34, 88-1199.

      Van Bommel, M., Van Prooijen, J., Elffers, H. & Van Lange, P.A.M. (2012) Be aware to
      care: Public self-awareness leads to a reversal of the bystander effect. Journal of
      Experimental Social Psychology, 48, 926-930.


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