Legal and Ethical Principles Chapter 2

Question 1

Explain the Good Samaritan law and how those laws relate to the EMR.

Answer 1

Good Samaritan Laws minimize exposure to liability and encourage passerby’s to provide emergency care to those in need. Those laws require the individual who is providing care to be doing so without compensation and to remain within a specified scope of practice. Depending on the specific role that you play as an EMR you may have a legal and/or ethical duty to assist those in need.

Question 11

Define Duty

Answer 11

The legal obligation to provide care.

Question 12

What is implied consent?

Answer 12

A legal position that assumes that an unresponsive or incompetent adult patient would consent to receiving emergency care if they could. This form of consent may apply to other types of patients. Example: the mentally ill

Question 13

What is standard of care?

Answer 13

The care that should be provided for any level of training based on local laws, administrative orders, and guidelines and protocols established by the local EMS system.

Question 14

Define ethics

Answer 14

The study of the principles that define behavior as right, good, and proper

Question 15

Define values

Answer 15

The personal beliefs that determine how a person actually behaves.

Question 16

Define consent

Answer 16

The legal term that means one needs to get formal permission for something to happen.

Question 17

Define competence

Answer 17

The quality of being adequately or well-qualified to make decisions both physically and intellectually.

Question 18

Define competent

Answer 18

Properly or sufficiently qualified or capable of making appropriate decisions about one’s own health or condition.

Question 19

What is expressed consent?

Answer 19

A competent adult’s informed decision to accept emergency care provided by an EMR. Also referred to as informed consent.

Question 20

What is informed consent?

Answer 20

Informed consent is the same as expressed consent; A competent adult informed decision to accept emergency care provided by an EMR.

Question 21

Define unresponsive

Answer 21

Having no reaction to verbal or painful stimuli; previously referred to as unconscious.

Question 22

Describe emancipated minors

Answer 22

A minor whose parents have entirely surrendered the right to care, custody, and earnings, and no longer are under any duty to support the minor. Emancipated minors are legally allowed to make their own decisions regarding medical care.

Question 23

Explain refusal of care

Answer 23

A patient states he/she does not want care. A patient does not have to speak to refuse care. If the patient shakes his/her head no or holds up a hand to signal you to stop, the patient has refused your help. Should the patient pull away from you, know that also maybe viewed as refusal of care.

Question 24

Define criminal law

Answer 24

The body of law dealing with crimes and punishment.

Question 25

Define battery

Answer 25

Unlawful physical contact.

Question 26

What is an advance directive?

Answer 26

A document that allows a patient to define in advance what their wishes are should they become incapacitated due to a medical illness or severe injury.

Question 27

Explain the term mandated reporter and how it relates to the EMR.

Answer 27

Mandated reporters are professionals who in the ordinary course of work are required to report whenever financial, physical, sexual, or other types of abuse or neglect have been observed or are suspected. All EMRs must report certain events or conditions that they know or suspect have occurred. Those events may include such things as exposures to certain infectious diseases, suspicious burns, vehicle crashes, drug related injuries, crimes that result in knife or gunshot wounds, child and elder abuse, domestic violence and rape.

Question 28

Explain the common elements of an advance directive.

Answer 28

1. Designation of an agent to make decisions on your behalf
2. Do not resuscitate order (DNR)
3. Choice to prolong or not prolong life
4. Pain relief
5. Donation of organs

Question 29

Explain the role of the EMR when confronted with an advance directive.

Answer 29

The presence of a DNR order does not mean ‘do not care.’ As an EMR you have a duty to provide appropriate comfort and care within the bounds of the DNR (administration of oxygen). It is also within the patients rights to withdraw the DNR order at any time.

Question 30

Define negligence

Answer 30

A failure to provide the expected standard of care.

Question 31

Define civil law (tort)

Answer 31

A body of law that addresses and provides remedies for civil wrongs not arising out of contractual obligations.

Question 32

Define breach of duty

Answer 32

A violation of the basic duty to act; failure to provide care to an acceptable standard.

Question 33

Define duty to act

Answer 33

A requirement that an EMR, at least while on duty, must provide care according to the department standard operating procedures. In some locations this duty to act may apply to paid EMRs when they are off-duty.

Question 34

Define abandonment

Answer 34

To leave the sick or injured patient before equal or more highly trained personnel can assume responsibility for care.

Question 35

Describe patient confidentiality as an EMR

Answer 35

The treatment of information that an individual has disclosed in a relationship of trust and with the expectation that it will not be disclosed to others.

Question 36

Define HIPPA

Answer 36

Health Insurance Portability Accountability Act (A lot of it dictates the extent to which protected health information can be shared.)

Question 37

Describe medical identification devices

Answer 37

These devices can be in the form of a necklace, arm or ankle bracelet, or card, and is meant to alert EMS personnel that a patient has a particular medical condition such as a heart problem, allergies, diabetes, or epilepsy. If the patient is unresponsive or unable to answer questions this device may provide important medical information.

Question 38

Explain the role of the EMR with respect to evidence preservation when working in or around an actual or potential crime scene.

Answer 38

When an EMR is providing care at a crime scene certain action should be taken to preserve evidence. Make as little impact on the scene as possible, only moving items necessary for patient care. Take special care to note the position of the patient and preserve any clothing you may remove or damage. Try not to cut through holes and clothing from gunshot wounds or stabbings. Remember to report any items you move or touch.

Question 39

Which of the following terms below is best defined as what an EMR is allowed to do based on the US Department of Transportation educational standards as well as state and local statutes and regulations?

A. Standard of care
B. Scope of practice
C. Duty
D. Negligence

Answer 39

B. Scope of practice

Question 40

Which of the following is an example of an advance directive

A. Protocols
B. Standing orders
C. Do not resuscitate order DNR
D. Medical direction

Answer 40

C. Do not resuscitate order DNR

Question 41

What type of consent is necessary from responsive, competent adult patients?

A. Implied
B. Applied
C. Absentee
D. Expressed

Answer 41

D. Expressed

Question 42

Which one of the following is NOT true about expressed consent?

A. It is also known as informed consent
B. It must always be given verbally by the patient
C. It can be given by parents of minors on their behalf
D. The patient must be informed of your intentions

Answer 42

B. It must always be given verbally by the patient

Question 43

You are caring for an overdose patient who is unresponsive. You are legally allowed to provide care based on what type of consent?

A. Informed
B. Expressed
C. Assumed
D. Implied

Answer 43

D. Implied

Question 44

Which one of the following patients may legally refuse care at the scene of an emergency?

A. 11-year-old boy who was hit by a car while riding his bicycle
B. 26-year-old unresponsive overdose patient
C. 46-year-old intoxicated driver of a vehicle involved in a collision
D. 68 year old alert woman having chest pain

Answer 44

D. 68 year old alert woman having chest pain

Question 45

Which of the following is NOT an element required for a claim of negligence?

A. Duty
B. Absence of duty
C. Damages
D. Causation

Answer 45

B. Absence of duty

Question 46

Most states require EMR and other EMS personnel to report incidents involving known or suspected:

A. Seizure activity
B. Accidental overdose
C. Child abuse or neglect
D. Pregnancy

Answer 46

C. Child abuse or neglect

Question 47

You have been dispatched to a shooting with three possible victims. Before entering the scene, you should:

A. Ensure that the scene has been made safe by law enforcement personnel.
B. Ensure that the scene has been made safe by fire personnel.
C. Obtain permission from your supervisor.
D. Wait for the EMTs to arrive.

Answer 47

A. Ensure that the scene has been made safe by law enforcement personnel.

Question 48

Which one of the following is MOST likely a breach of patient confidentiality by an EMR?

A. Provides detailed information about the patient to the nurse in the emergency department
B. Returns to the station and shares details of the call with colleagues
C. Shares details of the patient’s condition with the EMTs who are taking over care
D. Provides details about the emergency after being subpoenaed to the court

Answer 48

B. Returns to the station and shares details of the call with colleagues