Chapter 3-Medical, Legal, and Ethical Issues Flashcards
Define consent
Consent is the patients permission for the EMT to give them treatment
What is the foundation for consent?
Decision-making capacity
Define decision-making capacity
The ability of the patient to understand and process information from the EMT and to use it to make an informed decision
What is the term for a patient’s right to make decisions regarding their health and treatment?
Patient autonomy
What is another (legal) term for decision-making capacity?
Competence
What are the three types of consent?
Expressed, implied, and involuntary
In what situations do you assume implied consent?
When there is a threat to life or limb
When the patient is unconscious or unable to give consent
When the patient is intoxicated by drugs or alcohol
What should you try to do if possible before assuming implied consent?
Get consent from a spouse, relative, etc.
When do you apply involuntary consent?
When the patient is mentally ill, developmentally delayed, or experiencing a behavioral crisis.
What should you try to do before treating someone under involuntary consent, and if this isn’t possible, what should you do instead?
Get consent from a caregiver/guardian, if not, involve law enforcement.
What should you do when treating a minor and no parent is around to give consent?
Proceed with treatment
What is an emancipated minor?
Someone under the age of 18 or the legal age dictated by the state who in the eyes of the law may be treated as an adult for any of the following reasons:
(1) married, (2) a parent, (3) in the armed services, (4) no longer dependent of parents, (5) a court order has declared them emancipated.
What term describes a teacher/counselor’s ability to act in the stead of a parent
in loco parentis
Before you restrain a patient, what should you do?
contact medical control for permission
In what situations might you be able to restrain a patient?
If they pose a physical threat to themselves, you, or someone else
What are two ways to document expressed consent?
Have someone witness the patient express consent or right it in the run report
What constitutes confidential protected health information?
Any information you obtain while treating the patient
In what situations may you disclose protected health information?
When it comes to payment, treatment, or operations
In what situations are you required to share protected health information?
When issued a subpoena or in cases involving child abuse.
How can you tell if a patient is an organ donor?
If they possess a donor card or it’s stated on their drivers’ license
What are some examples of information contained in medical identification insignia?
DNR orders, allergies, diabetes, epilepsy, medications taken, and emergency contact info.
What must a DNR include for it to be valid?
Patient or legal guardian’s signature, physician’s signature, not expired
What would an advance directives do?
Indicate how what care/treatment you should give a patient should they become unable to make decisions (also may name a surrogate)
What are other terms for an advance directives?
health care directive or living will
What is a common situation in which an advance directives may be applied?
If a competent patient becomes comatose
What is the difference between scope of practice and standard of care
Scope of practice outlines what types of care/treatment you are allowed to give and what’s outside of your certification level; standard of care outlines how you should deliver the treatments that are within your scope of practice (for example, as medical research become more updated and relevant, the AHA may update the proper steps for CPR, which would mean that your standard of care has changed but not your scope of practice, you’re still providing CPR)
What entity establishes scope of practice usually?
State law
Who authorizes you to provide emergency medical care?
Medical director
What is negligence and what four elements must be present for it to apply?
Failure to provide standard of care; you must have been on duty, you must have breached your duty, damages were caused and you caused them
What is abandonment?
Unilateral termination of patient care by the EMT without the patient’s permission and without making arrangements for continuation of care
How do you prove you didn’t abandon a patient?
Obtain a signature on the patient care record
What is the difference between assault and battery?
Assault is putting someone in fear of bodily harm (eg restraint) whereas battery is unlawfully touching a person
What is the difference between kidnapping and false imprisonment?
Kidnapping is seizing, confining, or carrying away by force, and false imprisonment is unauthorized confinement of a patient.
What are the two types of signs of death?
Definitive and presumptive
What are some definitive signs of death?
Obvious mortal injury, dependent lividity, rigor mortis, putrefaction
What are some presumptive signs of death?
Unresponsive to painful stimuli, lack of pulse/heartbeat, absence of chest fall/rise, absence of pupillary reactivity, no systolic blood pressure, cyanosis, lowered body temp, no deep tendon or corneal reflexes
In what cases would you need multiple presumptive signs of death?
Sudden death caused by hypothermia, acute poisoning, or cardiac arrest
What are different entities that can establish standard of care?
the law, local customs, professional or institutional standards, textbooks, or states
What will be taken into consideration when judging your standard of care?
Issues concerning the safety of patient or rescuer, the level of confusion at the scene, the needs of other patients, the type of equipment you have available to you
What are the two situations in which you have a duty to act?
Your EMS’s policy states you must act in any emergency or you have been charged with responding to a specific medical emergency
After what point do you have a legal duty to act?
Once your ambulance has responded to a call
