Chapter 3 Medical, Legal, & Ethical Issues

Question 1

Scope of Practice

Answer 1

The action and care that EMT’s are legally allowed to perform in the state that the work. It also identifies which activities would be deemed illegal if practiced without a license.

Question 2

Standard of Care

Answer 2

Care that is expected to be provided by an EMT with similar training when managing a patient in a similar situation.

Question 3

2 Principles of Standard of Care

Answer 3

1) Did the EMT provide the right assessment and emergency care for the patient?
2) Did the EMT perform the assessment and emergency care properly?

Question 4

Duty to Act

Answer 4

refers to your legal obligation to provide service, weather you think the patient needs and ambulance or not.

Question 5

Duty to Act - Off Duty

Answer 5

Most states you have no more legal obligation to act than any other citizen. You could legally do the following:

• Stop and help a victim at the scene.
• Pass the scene and call for help.
• Pass the scene and not call for help.

Question 6

Duty to Act - Off Duty (states that require aid)

Answer 6

Some states require off duty EMT to stop at emergency and render aid

Question 7

Duty to Act - Important Note

Answer 7

When off duty. If a EMT stops at an accident he/she creates a Duty to Act by stopping.

Question 8

Duty to Patient

Answer 8

Respecting the right of the patient (provide competent care for injury-illness- emotional needs, confidentiality, privacy, & do no further harm.

Question 9

Duty to Self

Answer 9

obtain necessary credentials, maintains skills to level of proficiency & maintain good physical/mental health.

Question 10

Duty to Partner

Answer 10

Ensure that he is mentally and physically fit, to report alcohol/drug abuse on the job, & have their back.

Question 11

Duty to Equipment

Answer 11

Ensure that all equipment is in working order.

Question 12

Good Samaritan Law

Answer 12

are laws or acts offering legal protection to people who give reasonable assistance to those who are injured, ill, in peril, or otherwise incapacitated.

Question 13

Sovereign immunity

Answer 13

is the legal privilege by which the American federal, state, and tribal governments cannot be sued. Local governments in most jurisdictions enjoy immunity from some forms of suit, particularly in tort.

Question 14

Statue of Limitations

Answer 14

is an enactment in a legal system that sets the maximum time after an event that legal proceedings based on that event may be initiated.

Question 15

contributory negligence

Answer 15

It applies to cases where plaintiffs/claimants have, through their own negligence, contributed to the harm they suffered.

Question 16

Consent

Answer 16

permission before providing care

Under the law, the conscious, competent, and rational patient has the right to refuse or accept medical care.

Question 17

Informed consent

Answer 17

is a process for getting permission before conducting a healthcare intervention on a person.

Question 18

Expressed consent

Answer 18

Known as: Emergency doctrine
(consent which is not implied) may be in verbal, nonverbal, or written form and is clearly and unmistakably stated. Verbal consent is given by using verbal communication.
Nonverbal consent is given by using nonverbal communication.

Question 19

implied consent

Answer 19

is a controversial form of consent which is not expressly granted by a person, but rather inferred from a person’s actions and the facts and circumstances of a particular situation (or in some cases, by a person’s silence or inaction).

Question 20

minor consent

Answer 20

In most jurisdictions, a doctor or hospital may not legally treat a minor child without consent of a parent or legal guardian.

Exception: emancipated minors
a minor who is married, pregnant, a parent, financially independent living away from home, in the armed forces, declared by a court.

Question 21

involuntary consent

Answer 21

refers to medical treatment undertaken without a person’s consent. In almost all circumstances, involuntary treatment refers to psychiatric treatment administered despite an individual’s objections. These are typically individuals who have been diagnosed with a mental illness and are deemed by a court to be a danger to themselves or others.

Question 22

Advance directive

Answer 22

is a set of written instructions that a person gives that specify what actions should be taken for their health, if they are no longer able to make decisions due to illness or incapacity.

Question 23

DNR (Do Not Resuscitate)

Answer 23

is a legal order written either in the hospital or on a legal form to respect the wishes of a patient not to undergo CPR or advanced cardiac life support (ACLS) if their heart were to stop or they were to stop breathing.

Question 24

Living Will

Answer 24

A living will is a legal document that a person uses to make known his or her wishes regarding life prolonging medical treatments. It can also be referred to as an advance directive, health care directive, or a physician’s directive.

Question 25

Durable Power of Attorney (health care proxy)

Answer 25

designates a person who is legally empowered to make health care decisions for the signer of the document if unable to do so for themselves.

Question 26

Physicians orders for life sustaining treatment (POLST)

Answer 26

is both a holistic method of planning for end-of-life care and a specific set of medical orders that ensure patients’ wishes are honored. The POLST Paradigm is built upon conversations between patients, loved ones, and health care professionals, during which patients can determine the extent of care they wish to receive. As a result of these conversations, patients may elect to create a POLST form, which translates their wishes into actionable medical orders. The POLST form assures patients that health care professionals will provide only the care that patients themselves wish to receive, and decreases the frequency of medical errors.

Question 27

Steps to Protect yourself in a DNR or POLST situation

Answer 27

1) consider initiating treatment immediately so that if the issue cannot be resolved you are not found negligent for not providing treatment or delayed treatment, (2) contact medical direction on how to proceed, (3) continue treatment until the problem has been solved.

Question 28

Competency

Answer 28

A patient is deemed to be lucid if he is able to accurately prove orientation to “person, place, and time.”

Question 29

Refusal of treatment

Answer 29

Under the law, to refuse treatment or transport a patient must be informed of and fully understand the treatment, and all the potential risks, and the consequences of refusal, up to and including the possibility of death.

Question 30

Steps to protect self in Refusal of treatment situation

Answer 30

1) explain treatment and consequences of refusal
2) have patient sign a release from liability form
3) Document everything!!!!

Question 31

breach of your legal duty

Answer 31

2 types of liability in breach: criminal & civil

Question 32

Tort

Answer 32

is a civil wrong, act, or damage where a plaintiff seeks monetary compensation.

Question 33

Negligence

Answer 33

is a tort were there is no intent to do any harm to a patient but in which there was a breach of duty to act.

Question 34

proximate cause

Answer 34

it must be determined that the injuries suffered by the patient were a direct cause of the EMT.

Question 35

Intentional tort

Answer 35

is an action knowingly committed by an individual that is considered to be civilly wrong under the law.

Example: abandonment, assault, battery, false imprisonment, & defamation.

Question 36

Abandonment (EMT)

Answer 36

if you stop treatment without transferring care to another competent professional of equal or high licensure

Question 37

Assault

Answer 37

is the willful threat to inflict harm on a patient.

Can occur without touching

If the patient has the apprehension of bodily harm, and the EMT has the ability to do so it would be consider assault.

Question 38

Battery

Answer 38

is the act of touching a patient without his consent.

Question 39

False imprisonment

Answer 39

taking a patient to a hospital against his wishes

Question 40

Defamation

Answer 40

releasing information to the public either written or spoken that is construed to be damaging to that’s person’s character, reputation, or standing within the community

Question 41

Slander

Answer 41

is the spoken form of defamation

Question 42

Libel

Answer 42

is putting the false or damaging statement in written form or via mass media.

Question 43

Confidentiality

Answer 43

is a set of rules or a promise that limits access or places restrictions on certain types of information.

EMT’s are require to keep confident patient information.

Question 44

The Health Insurance Portability and Accountability Act of 1996

Answer 44

defines policies, procedures and guidelines for maintaining the privacy and security of individually identifiable health information as well as outlining numerous offenses relating to health care and sets civil and criminal penalties for violations.

This act gives the right to privacy to individuals from age 12 through 18. The provider must have a signed disclosure from the affected before giving out any information on provided health care to anyone, including parents

Question 45

(COBRA) Consolidated Omnibus Budget Reconciliation Act of 1985

Answer 45

act that, among other things, mandates an insurance program giving some employees the ability to continue health insurance coverage after leaving employment.

Question 46

Medical Emergency Labor Treatment Act

Answer 46

It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.

Question 47

Donors and Organ Harvesting

Answer 47

An individual is a patient first and a donor last.

Question 48

Medical Identification insignia

Answer 48

has important medical information

Bracelet, necklace, or card

Question 49

Medical Alert tattoo

Answer 49

placed on wrist, arm, chest

Question 50

Signs of death (in the Field)

Answer 50

• absence of a pulse, breathing, breathe sounds
• Complete unresponsiveness to stimuli
• No eye movement or pupil response
• Absence of blood pressure
• No Reflexes

Question 51

Medical examiner called for

Answer 51

1. Homicide
2. Suicide
3. Violent death
4. Crash-related death
5. Unusual scene characteristics (burns, electrocution).
6. SIDS
7. DOA

Question 52

Special Reporting situations

Answer 52

abuse, crime, & drug related injuries

Question 53

Baby Safe Haven law

Answer 53

“Baby Moses laws”, in reference to the religious scripture) are statutes in the United States that decriminalize the leaving of unharmed infants with statutorily designated private persons so that the child becomes a ward of the state. “Safe-haven” laws typically let mothers remain nameless to the court, often using a numbered bracelet system as the only means of linking the baby to the mother.