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Modern emergency management policy is built around the concepts of shared responsibility and the development of resilient communities. Drawing on the Australian context, this chapter argues that giving effect to these policy directions will require negotiation between stakeholders and an inevitable trade in values, interests, and resources. The chapter identifies an apparent contradiction at the heart of modern disaster management: that improvements in establishing professional emergency and risk management services may have reduced the capacity of individuals and local communities to take responsibility for disaster preparation and response.

Two meanings of the word myth informed the origins of this volume and its constituent chapters: myth as an archetypical narrative that societies and cultures use to embody value-laden lessons about both the natural world and human nature (myths to live by); and myth as a nefarious fabrication that imperils those who believe it (myths to die by). Throughout this volume, we use the Greek myth of Cassandra – the heroine of Troy who unsuccessfully forewarned her community of avoidable future disaster – as an archetype for the often heroic efforts of those in our day who seek to forewarn us of altogether foreseeable future disasters associated with both natural forces and human contrivance. We also explore the deadly myths of delusion – those which weave an illusory cocoon of invincibility around those who increasingly inhabit increasingly disaster-prone landscapes. Each chapter in this volume tells stories about what happens when these two meanings of myth collide, and of how better heeding the message of present-day Cassandras might help us to dispel the myths of delusion.

The law of catastrophic wildfire prevention and response in the Mediterranean member states of the European Union stands in stark contrast to that of common law nation states such as Australia and the United States. This is due primarily to the higher levels of reciprocal moral and legal obligations between governments and citizens established in various sources of European law. Focusing on the relationship between the EU, Spain, and the Autonomous Community of Catalonia within Spain, this chapter describes these three legal frameworks as they are nested within each other, followed by some case law examples of these laws in action. We compare and contrast the philosophical assumptions underlying the utilitarian cost–benefit approach to regulatory justification used in the United States with the precautionary principle model emblematic of the European Union, the member state of Spain, and its Autonomous Community of Catalonia. Regardless of approach, protection of the public health, safety, and welfare will only be as robust and effective as the government agencies that have that responsibility, and the degree of cooperation with those agencies of the citizens they serve.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.