Position paper on the reform of emergency care
English translation – the German version dated 5 August 2026 is authoritative in case of discrepancies.
Objective
Ethical Saving / Medicalcooling advocates a product-neutral innovation and evaluation pathway for new prehospital diagnostic and treatment methods. The aim is not preferential access for any specific technology, but a transparent route into scientifically controlled evaluation.
1. Open evaluation pathways to emergency medical services
The existing legal mechanisms for evaluating new methods should be made practically accessible to prehospital emergency care. Innovation in the ambulance and emergency medical setting often fails because studies cannot be initiated under realistic reimbursement and organisational conditions.
2. Create transport-independent evaluation reimbursement
Necessary prehospital services should be reimbursable during approved evaluation projects even when they are not directly linked to a patient transport. This would allow emergency medical services to participate in scientific studies without having to absorb all additional costs.
3. Patient safety and evidence remain decisive
The proposed pathway must not create automatic market access or bypass regulatory requirements. Appropriate study design, ethics approval, data protection, medical device law, patient safety and robust evidence remain essential.
4. Scientific context
Early neuroprotective approaches after cardiac arrest remain an area of active research. Existing evidence does not establish a clinical benefit of Medicalcooling or a general class effect of early cooling methods. The purpose of an evaluation pathway is precisely to generate reliable evidence where important questions remain unresolved.
5. Product-neutral design
The proposed framework should be open to suitable new prehospital methods regardless of manufacturer or project. Medicalcooling is one example illustrating the structural problem, not a request for privileged treatment.
Requested policy direction
We therefore recommend adapting the relevant evaluation and reimbursement rules so that scientifically controlled prehospital innovation can be tested under realistic conditions, with clear safeguards and transparent criteria.
Document date: 5 August 2026.
