Germany’s emergency paramedics, the Notfallsanitäter, train for three years. Since 4 March 2021, Section 2a of the Paramedics Act has given them a defined right to act on their own. Until the emergency doctor arrives, or until other medical care begins, including care by a doctor over video, they may carry out medical measures on their own responsibility. These include invasive measures and medication. The law sets two conditions. The paramedics must have learned the measure in their training and must master it, erlernt haben und beherrschen. The measure must also be necessary to avert danger to life or serious lasting harm to the patient. Before the new section, such steps rested on the general rule of necessity in Section 34 of the Criminal Code. During the debate on the law in December 2020, the paramedics’ professional association described the dilemma: a paramedic faces a conflict of conscience over whether to act invasively or to wait for the emergency doctor.