Chapter 3: Medical, Legal, and Ethical Issues

Question 1

What phrase or word matches this definition?

A federal law enacted to combat the practice of patient dumping and that pays particular attention to the practice of sending women in labor to distant hospitals; prevents emergency department staff from denying medical screening or stabilizing treatment, or inappropriately transferring a patient whose condition is not stable to another hospital.

Answer 1

Emergency Medical Treatment and Active Labor Act (EMTALA)

Question 2

What phrase or word matches this definition?

Unilateral termination of care by the EMT without the patient’s consent and without making provisions for transferring care to another medical professional with the skills and training necessary to meet the needs of the patient.

Answer 2

Abandonment

Question 3

What is the AEMT’s obligation in reporting abuse?

Answer 3

Most states require AEMTs to report abuse and protect them from liability for libel, slander, or defamation of character.

Question 4

What phrase or word matches this definition?

Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also a living will or health care directive.

Answer 4

Advance Directive

Question 5

What phrase or word matches this definition?

Cooling of the body after death until it matches the ambient temperature.

Answer 5

Algor Mortis

Question 6

What phrase or word matches this definition?

An action instituted by the government against a person for violation of criminal law.

Answer 6

Criminal Prosecution

Question 7

What phrase or word matches this definition?

An established process to determine the qualifications necessary to be allowed to practice a particular profession, or to function as an organization.

Answer 7

Credentialing

Question 8

What phrase or word matches this definition?

An unauthorized act committed outside the scope of medical practice defined by law.

Answer 8

Malfeasance

Question 9

What phrase or word matches this definition?

The manner in which principles of ethics are incorporated into professional conduct.

Answer 9

Applied Ethics

Question 10

What phrase or word matches this definition?

Appropriate act performed in an improper manner, such as a medication administered at the wrong dose.

Answer 10

Misfeasance

Question 11

What phrase or word matches this definition?

Unlawfully placing a patient in fear of bodily harm.

Answer 11

Assault

Question 12

What phrase or word matches this definition?

Basing current action on lessons, rules, or guidelines derived from previous similar experiences.

Answer 12

Precedence

Question 13

What phrase or word matches this definition?

Unlawfully touching a patient or providing emergency care without consent.

Answer 13

Battery

Question 14

What phrase or word matches this definition?

The study of ethics related to issues that arise in health care.

Answer 14

Bioethics

Question 15

What phrase or word matches this definition?

Disclosure of information without proper authorization.

Answer 15

Breach of Confidentiality

Question 16

What phrase or word matches this definition?

Compensation for injury; awarded by a court.

Answer 16

Damages

Question 17

What phrase or word matches this definition?

Damages awarded in a civil lawsuit that are intended to restore the plantiff to the same condition that he, she, or they was in prior to the incident.

Answer 17

Compensatory Damages

Question 18

What phrase or word matches this definition?

Able to make rational decisions about personal well-being.

Answer 18

Competent

Question 19

What phrase or word matches this definition?

Permission to render care.

Answer 19

Consent

Question 20

What phrase or word matches this definition?

A legal defense that may be raised when the defendant thinks that the conduct of the plaintiff somehow contributed to any injuries or damages that were sustained by the plaintiff.

Answer 20

Contributory Negligence

Question 21

What phrase or word matches this definition?

Ability to understand and process information and make a choice regarding appropriate medical care.

Answer 21

Decision-Making Capacity

Question 22

What phrase or word matches this definition?

The communication of false information about a person that is damaging to that person’s reputation or standing in the community.

Answer 22

Defamation

Question 23

What are the definitive signs of death?

Answer 23

• Obvious mortal damage (i.e. decapitation)
• Dependent Lividity
• Rigor Mortis
• Algor Mortis
• Putrefaction

Question 24

What phrase or word matches this definition?

Blood settling to the lowest point of the body, causing discoloration of the skin; a definitive sign of death.

Answer 24

Dependent Lividity

Question 25

# What phrase or word matches this definition? Oral questions asked of parties and witnesses under oath.

Answer 25

Depositions

Question 26

# What phrase or word matches this definition? The phase of a civil lawsuit where the plaintiff and defense obtain information from each other that will enable the attorneys to have a better understanding of the case and which will assist in negotiating a possible settlement or in preparing for trial. Includes depositions, interrogatories, and demands for production of records.

Answer 26

Discovery

Question 27

# What does the acronym mean? DNR

Answer 27

Do Not Resuscitate

Question 28

What requirements must be met in order for DNR orders to be valid?

Answer 28

* Clear statement of the patient's medical problem(s) * Signature of patient or legal guardian * Signature of one or more physicians or other licensed health care provider * DNR orders that contain expiration dates must be dated in the preceding 12 months (some states only).

Question 29

# What phrase or word matches this definition? Written documentation by a physician giving permission to medical personnel not to attempt resuscitation in the event of cardiac arrest.

Answer 29

Do Not Resuscitate (DNR) Order

Question 30

What is the AEMT's obligation in reporting drug-related injuries?

Answer 30

Some states have established confidentiality for these cases and excuse certain specified people from reporting drug cases if, in the opinion of those people, withholding reporting is necessary for the proper treatment of the patient.

Question 31

# What phrase or word matches this definition? A type of advance directive executed by a competent adult that appoints another individual to make a decision on their behalf, in the event that the person making the appointment loses decision-making capacity.

Answer 31

Durable Power of Attorney for Health Care

Question 32

# What phrase or word matches this definition? A medicolegal term relating to certain personnel who either by statute or by function have a responsibility to provide care.

Answer 32

Duty to Act ## Footnote *The AEMT has an obligation to provide care when on the job and to do so in a manner that is consistent with teh standard of care established by training and local protocls.*

Question 33

# What phrase or word matches this definition? A person who is under the legal age in a given state but, because of other circumstances, is legally considered an adult.

Answer 33

Emancipated Minor

Question 34

# What phrase or word matches this definition? A serious situation, such as injury or illness that threatens the life or welfare of a person or group of people and requires immediate intervention.

Answer 34

Emergency

Question 35

# What phrase or word matches this definition? The principle of law that permits a health care provider to treat a patient in an emergency situation when the patient is incapable of granting consent because of an altered level of consciousness, disability, the effects of drugs or alcohol, or the patient's age.

Answer 35

Emergency Doctrine

Question 36

# What phrase or word matches this definition? Immediate care or treatment.

Answer 36

Emergency Medical Care

Question 37

What roles and responsibilities do AEMTs have in court?

Answer 37

* When subpoenaed, immediately notify the director of your service and legal counsel. * Remain neutral. * Provide the facts as you observed them. * Do not take sides. * Review your run report prior to your court appearance.

Question 38

# What does this acronym mean? EMTALA

Answer 38

Emergency Medical Treatment and Active Labor Act

Question 39

What questions should an AEMT ask themselves when it comes to ethical decision-making?

Answer 39

* Is the decision in the best interests of the patient? * Is the decision based on logic and reason rather than emotion? * Does the decision protect the patient's rights? * Would you agree to the same decision if you were the patient? * Would you make the same decision again in similar circustances? * Can you defend this decision to others? * How will the consequences of your decision provide the greatest benefit in view of all of the alternatives? * Have you involved online medical control in your decision making?

Question 40

# What phrase or word matches this definition? The philosophy of right and wrong, of moral duties, and of ideal professional behavior.

Answer 40

Ethics

Question 41

# What phrase or word matches this definition? A type of consent in which a patient gives verbal or nonverbal authorization for provision of care or transport.

Answer 41

Expressed Consent

Question 42

# What phrase or word matches this definition? Failure to perform a required or expected act.

Answer 42

Nonfeasance

Question 43

# What phrase or word matches this definition? The confinement of a person without legal authority or the person's consent.

Answer 43

False Imprisonment

Question 44

What is the AEMT's obligation in reporting an injury during the commission of a felony?

Answer 44

Many states require reporting of injuries that is likely to have occurred during the commision of a crime (i.e. gunshot or knife wound).

Question 45

# What phrase or word matches this definition? The act of physically preventing an individual from initiating any physical action.

Answer 45

Forcible Restraint

Question 46

When can forcible restraint be used?

Answer 46

Only in circumstances where there is risk to the patient or others. AEMTs should consult medical control for authorization or contact law enforcement personnel. In some states, only a police officer may forcible restrain a patient.

Question 47

# What phrase or word matches this definition? Statutory provisions enacted by many states to protect citizens from liability for errors and omissions in giving good faith emergency medical care, unless there is wanton, gross, or willful negligence.

Answer 47

Good Samaritan Laws ## Footnote *An AEMT is a good samaritan when off duty.*

Question 48

# What phrase or word matches this definition? Legal doctrine that can protect an EMS provider from being sued or which may limit the amount of the monetary judgment that the plaintiff may recover; generally applies only to EMS systems that are operated by municipalities or other governmental entities.

Answer 48

Governmental Immunity

Question 49

# What phrase or word matches this definition? Conduct that constitutes a willful or reckless disregard for a duty or standard of care.

Answer 49

Gross Negligence

Question 50

# What phrase or word matches this definition? A written document that specifies medical treatment for a competent patient, should they become unable to make decisions. Also known as an advance directive or a living will.

Answer 50

Health Care Directive

Question 51

# What phrase or word matches this definition? A type of advance directive executed by a competent adult that appoints another individual to make medical treatment decisions on their behalf in the event that the person making the appointment loses decision-making capacity. A durable power of attorney.

Answer 51

Health Care Proxy

Question 52

# What does this acronym mean? HIPAA

Answer 52

Health Insurance Portability and Accountability Act

Question 53

How does consent impact decision making?

Answer 53

An adult who is conscious, rational and capable of making informed decisions has a legal right to refuse care, even though they may be ill or injured. A patient may also consent to some aspects of care and not others. As an AEMT, you may try to influence a patient's decision making, but are not allowed to make a decision for the patient under these circumstances.

Question 54

# What phrase or word matches this definition? Type of consent in which a patient who is unable to give consent is given treatment under the legal assumption that they would want treatment.

Answer 54

Implied Consent

Question 55

# What phrase or word matches this definition? In a civil lawsuit, the person against whom a legal action is brought.

Answer 55

Defendant

Question 56

# What phrase or word matches this definition? In a civil lawsuit, the person who bring a legal action against another person.

Answer 56

Plaintiff

Question 57

# What phrase or word matches this definition? Refers to the legal responsibility of a person or organization to take on some of the functions and responsibilities of a parent.

Answer 57

In Loco Parentis

Question 58

# What phrase or word matches this definition? Permission for treatment given by a competent patient after the potential risks, benefits, and alternatives have been explained.

Answer 58

Informed Consent

Question 59

# What phrase or word matches this definition? Written questions that the defense and plaintiff send to one another.

Answer 59

Interrogatories

Question 60

# What phrase or word matches this definition? The seizing, confining, abducting, or carrying away of a person by force, including transporting a competent adult for medical treatment without their consent.

Answer 60

Kidnapping

Question 61

# What phrase or word matches this definition? False and damaging information about a person that is communicated in writing.

Answer 61

Libel

Question 62

# What phrase or word matches this definition? Local protocols, usually pertaining to a particular service or area.

Answer 62

Standing Orders

Question 63

Where might valuable medical information be located?

Answer 63

* Bracelet * Necklace * Key Chain * Card USB Flash Drive * Phone

Question 64

# What phrase or word matches this definition? A term relating to medical jurisprudence (law) or forensic medicine.

Answer 64

Medicolegal

Question 65

# What phrase or word matches this definition? A code of conduct that can be defined by society, religion, or a person, affecting character, conduct, and conscience.

Answer 65

Morality

Question 66

# What phrase or word matches this definition? Failure to provide the same care that a person with similar training would provide.

Answer 66

Negligence

Question 67

# What phrase or word matches this definition? A theory that may be used when the conduct of the person being sued is alleged to have occurred in clear violation of a statute.

Answer 67

Negligence Per Se

Question 68

How should an organ donor be treated?

Answer 68

Treat the same way you would treat any other patient. Use all mean necessary to keep them alive. Not going so will lead to damaged organs that cannot be used.

Question 69

# What phrase or word matches this definition? The right of a patient to make informed choices regarding their health.

Answer 69

Patient Autonomy

Question 70

# What does the acronym mean? PHI

Answer 70

Protected Health Information

Question 71

# What phrase or word matches this definition? Precise and detailed plans for a regimen of therapy (for example, advanced cardiac life support algorithms).

Answer 71

Protocols

Question 72

What are the presumptive signs of death?

Answer 72

* Unresponsive to painful stimuli * Lack of a carotid pulse or heartbeat * Absence of chest rise and fall * No deep tendon or corneal reflexes * Absence of pupillary reactivity * No systolic blood pressure * Profound cyanosis * Lowered or decreased body temperature

Question 73

# What phrase or word matches this definition? Any information about health status, provision of health care, or payment of health care, or payment for health care that can be linked to an individual. This is interpreted rather broadly and includes any part of a patient's medical record or payment history.

Answer 73

Protected Health Information (PHI)

Question 74

# What phrase or word matches this definition? When a person who has a duty abuses it, and causes harm to another individual, the EMT, the agency, and/or the medical director may be sued for negligence.

Answer 74

Proximate Causation

Question 75

# What phrase or word matches this definition? Damages that are sometimes awarded in a civil lawsuit when the conduct of the defendant was intentional or constituted a reckless disregard for the safety of the public.

Answer 75

Punitive Damages

Question 76

# What phrase or word matches this definition? Decomposition of body tissues; a definitive sign of death.

Answer 76

Putrefaction

Question 77

What obligation(s) does the AEMT have if a patient refuses treatment or transport?

Answer 77

* Involve medical control and document consultation * Document the following: * Assessment * Description of treatment you think is necessary * Any possible risks of treatment * Availability of alternative treatments * Possible consequences of refusing treatment * Make sure patient understands items above * Assess patient's ability to make an informed decision * Have the patient and witnesses if possible sign an Against Medical Advice (AMA) form. * Encourage the patient up to 3x if situation allows before leaving the scene * Advise patient to contact a personal physician asap

Question 78

What is the AEMT's obligation in reporting childbirth?

Answer 78

Most states require that the birth is reported.

Question 79

# What phrase or word matches this definition? When the AEMT or an EMS system is held liable even when the plaintiff is unable to clearly demonstrate how an injury occurred.

Answer 79

Res Ipsa Loquitor

Question 80

# What phrase or word matches this definition? Stiffening of the body muscles; a definitive sign of death.

Answer 80

Rigor Mortis

Question 81

What action steps should an AEMT take at the scene of a crime?

Answer 81

* Ensure personal safety. * Notify dispatcher immediately. * Do not allow scene to stop you from rendering life-saving emergency care. * Be careful not to disturb crime scene any more than absolutely necessary. * Make notes / drawings of... * The position of patient * The presence and position of weapons or other objects * If possible, do not cut through holes in clothing created by weapons. * Avoid walking through blood. * Try to avoid leaving footprints in dirt or grass or near crime scene. * For sexual assault cases, try to persuade victim not to shower or clean themself. * Confer periodically with local authorities / be aware of their wishes.

Question 82

# What phrase or word matches this definition? Most commonly defined by the state law; outlines the care that the AEMT is able to provide for the patient. This is further defined by the medical director through protocols and standing orders.

Answer 82

Scope of Practice

Question 83

# What phrase or word matches this definition? False and damaging information about a person that is communicated by the spoken word.

Answer 83

Slander

Question 84

# What phrase or word matches this definition? Written, accepted levels of emergency care expected by reason of training and profession; written by legal or professional organizations so that patients are not exposed to unreasonable risk or harm.

Answer 84

Standard of Care

Question 85

# What phrase or word matches this definition? The time within which a case must be commenced.

Answer 85

Statute of Limitations

Question 86

# What phrase or word matches this definition? The law enacted in 1996 that provides for criminal sanctions as well as for civil penalties for releasing a patient's protected health information in a way not authorized by the patient.

Answer 86

Health Insurance Portability and Accountability Act (HIPAA)

Question 87

# What phrase or word matches this definition? The process whereby a competent authority, usually the state, allows people to perform a regulated job, trade, or profession.

Answer 87

Licensure

Question 88

# What phrase or word matches this definition? A wrongful act that gives rise to a civil lawsuit.

Answer 88

Torts

Question 89

# What phrase or word matches this definition? Occurs when a person accused of negligence fails to act as another person with similar training would act under the same or similar circumstances.

Answer 89

Breach of Duty

Question 90

# What phrase or word matches this definition? A process in which a person, an institution, or a program is evaluated and recognized as meeting certain predetermined standards to provide safe and ethical patient care.

Answer 90

Certification

Question 91

# What phrase or word matches this definition? An action instituted by a person or entity against another person or entity.

Answer 91

Civil Lawsuit

Question 92

# What phrase or word matches this definition? An action instituted by the government against a person for violation of criminal law.

Answer 92

Criminal Prosecution

Question 93

# What phrase or word matches this definition? In a legal context, legal protection from penalties that could normally be incurred under the law.

Answer 93

Immunity