Chapter 3 Medical, Legal, and Ethical Issues

Question 1

Discuss the scope of practice and standards of care that are imposed on you as an emergency medical technician (EMT) and advanced emergency medical technician (AEMT). (p 90-92)

Answer 1

for AEMTs, which is most commonly defined by state law, outlines the boundaries for the emergency medical care you are permitted to provide for the patient.

Question 2

Differentiate between licensure and certification as they apply to your practice as an EMT. (p 95)

Answer 2

Certification is the process by which an individual, institution, or program is evaluated and recognized as meeting certain predetermined standards to ensure safe and ethical patient care.

Licensure is the process by which a competent authority, usually the state, grants permission to practice a job, trade, or profession.

Question 3

Discuss the four factors that determine negligence. (pp 96-97)

Answer 3

Determination of negligence is based on the following four factors:
1. Duty
2. Breach of duty
3. Damages
4. Proximate cause

Question 4

Discuss the issues of abandonment, assault, battery, kidnapping, and false imprisonment, including the implications for you as an AEMT. (pp 97-98)

Answer 4

Abandonment is a form of negligence that involves the termination of emergency medical care without the patient’s consent.

Assault is defined as threatening a person or causing a person fear of immediate bodily harm without the person’s consent—regardless of whether the threat of harm is actually carried out.

Battery is unlawfully touching another person.

Kidnapping is the seizing, confining, abducting, or carrying away of a person by force. In theory, this might include a situation where a patient is transported against their will.

False imprisonment is defined as the unauthorized confinement of a person that lasts for an appreciable period.

Question 5

Describe your legal duty to act. (p 96)

Answer 5

It is an obligation to pro- vide patient care in a manner that is consistent with the standard of care established by training and local protocols.

Question 6

Compare defamation, slander, and libel. (p 99)

Answer 6

defamation, which is intentionally making a false statement through written or verbal communication that injures a person’s good name or reputation.

Slander is making a false verbal statement that injures a person’s good name.

Question 7

Define consent, including how it relates to decision-making capacity. (p 100)

Answer 7

If a person is alert, rational, and capable of making informed decisions, then the person has a legal right to refuse emergency medical care, even though ill or injured.

Question 7

Describe situations in which Good Samaritan laws or immunity would apply. (pp 99-100)

Answer 7

Some laws provide Good Samaritan protection for anyone who stops to render aid during an emergency, whereas other laws only provide protection for those with no medical training.

In the United States, this concept, called sovereign immunity, has taken the form of legislation that identifies only limited types of lawsuits that can be filed against govern- ment agencies.

Question 8

Compare expressed consent, informed consent, implied consent, and involuntary consent. (pp 101-104)

Answer 8

(or actual consent) is a type of consent that occurs when patients acknowledge that they want you to provide emergency medical care or transport.

1. Describe the suspected illness or injury to the patient.
2. Describe the treatment you would like to ad- minister, and list the potential risks associated with the proposed treatment.
3. If the patient adamantly refuses to be trans- ported, discuss any alternative types of
   treatment available and recommend that the person be seen by a physician regardless of the mode of transportation.
4. Advise the patient regarding any potential consequences of refusing treatment.

When individuals are unresponsive or otherwise unable to make a rational, informed decision about their medical care, and are therefore unable to give consent, the law assumes that the patients would consent to care and transport to a medical facility if they were able to do so

Question 9

Discuss consent by minors for treatment or transport. (pp 103-104)

Answer 9

In every state, if a parent cannot be reached to provide consent, then health care pro- viders are allowed to give emergency medical care to a child. However, in some states, a minor can give valid consent to receive emergency medical care, depending on the minor’s age and maturity level.

Question 10

Describe local emergency medical services (EMS) system protocols for using forcible restraint. (pp 104-105)

Answer 10

is the act of physically subduing a patient to prevent harm. Forcible restraint may be necessary if you are confronted with patients who are in need of medical treatment and trans- portation but are physically violent and present a significant risk to others.

Question 10

Discuss the importance of do not resuscitate orders and local protocols as they relate to the EMS environment. (pp 106-108)

Question 11

Explain your role and obligations if a patient refuses treatment or transport. (pp 105-106)

Question 12

Describe ethics and morality, including the implications for you as an EMT. (pp 106-108)

Question 13

Explain the mandatory reporting requirements for special situations, including abuse or neglect, drug- or felony-related injuries, childbirth, and crime scenes. (pp 112-113)

Question 13

Describe the relationship between patient communications, confidentiality, and the Health Insurance Portability and Accountability Act (HIPAA). (pp 109-111)

Question 14

Describe the presumptive and definitive signs of death. (pp 113-114)

Question 15

Explain how to manage patients who are identified as organ donors. (p 115)

Question 16

Recognize the importance of medical identification devices in treating the patient. (pp 115-116)