Chapter 3-Medical, Legal, and Ethical Issues

Question 1

Define consent

Answer 1

Consent is the patients permission for the EMT to give them treatment

Question 2

What is the foundation for consent?

Answer 2

Decision-making capacity

Question 3

Define decision-making capacity

Answer 3

The ability of the patient to understand and process information from the EMT and to use it to make an informed decision

Question 4

What is the term for a patient’s right to make decisions regarding their health and treatment?

Answer 4

Patient autonomy

Question 5

What is another (legal) term for decision-making capacity?

Answer 5

Competence

Question 6

What are the three types of consent?

Answer 6

Expressed, implied, and involuntary

Question 7

In what situations do you assume implied consent?

Answer 7

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

Question 8

What should you try to do if possible before assuming implied consent?

Answer 8

Get consent from a spouse, relative, etc.

Question 9

When do you apply involuntary consent?

Answer 9

When the patient is mentally ill, developmentally delayed, or experiencing a behavioral crisis.

Question 10

What should you try to do before treating someone under involuntary consent, and if this isn’t possible, what should you do instead?

Answer 10

Get consent from a caregiver/guardian, if not, involve law enforcement.

Question 11

What should you do when treating a minor and no parent is around to give consent?

Answer 11

Proceed with treatment

Question 12

What is an emancipated minor?

Answer 12

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.

Question 13

What term describes a teacher/counselor’s ability to act in the stead of a parent

Answer 13

in loco parentis

Question 14

Before you restrain a patient, what should you do?

Answer 14

contact medical control for permission

Question 15

In what situations might you be able to restrain a patient?

Answer 15

If they pose a physical threat to themselves, you, or someone else

Question 16

What are two ways to document expressed consent?

Answer 16

Have someone witness the patient express consent or right it in the run report

Question 17

What constitutes confidential protected health information?

Answer 17

Any information you obtain while treating the patient

Question 18

In what situations may you disclose protected health information?

Answer 18

When it comes to payment, treatment, or operations

Question 19

In what situations are you required to share protected health information?

Answer 19

When issued a subpoena or in cases involving child abuse.

Question 20

How can you tell if a patient is an organ donor?

Answer 20

If they possess a donor card or it’s stated on their drivers’ license

Question 21

What are some examples of information contained in medical identification insignia?

Answer 21

DNR orders, allergies, diabetes, epilepsy, medications taken, and emergency contact info.

Question 22

What must a DNR include for it to be valid?

Answer 22

Patient or legal guardian’s signature, physician’s signature, not expired

Question 23

What would an advance directives do?

Answer 23

Indicate how what care/treatment you should give a patient should they become unable to make decisions (also may name a surrogate)

Question 24

What are other terms for an advance directives?

Answer 24

health care directive or living will

Question 25

What is a common situation in which an advance directives may be applied?

Answer 25

If a competent patient becomes comatose

Question 26

What is the difference between scope of practice and standard of care

Answer 26

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)

Question 27

What entity establishes scope of practice usually?

Answer 27

State law

Question 28

Who authorizes you to provide emergency medical care?

Answer 28

Medical director

Question 29

What is negligence and what four elements must be present for it to apply?

Answer 29

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

Question 30

What is abandonment?

Answer 30

Unilateral termination of patient care by the EMT without the patient’s permission and without making arrangements for continuation of care

Question 31

How do you prove you didn’t abandon a patient?

Answer 31

Obtain a signature on the patient care record

Question 32

What is the difference between assault and battery?

Answer 32

Assault is putting someone in fear of bodily harm (eg restraint) whereas battery is unlawfully touching a person

Question 33

What is the difference between kidnapping and false imprisonment?

Answer 33

Kidnapping is seizing, confining, or carrying away by force, and false imprisonment is unauthorized confinement of a patient.

Question 34

What are the two types of signs of death?

Answer 34

Definitive and presumptive

Question 35

What are some definitive signs of death?

Answer 35

Obvious mortal injury, dependent lividity, rigor mortis, putrefaction

Question 36

What are some presumptive signs of death?

Answer 36

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

Question 37

In what cases would you need multiple presumptive signs of death?

Answer 37

Sudden death caused by hypothermia, acute poisoning, or cardiac arrest

Question 38

What are different entities that can establish standard of care?

Answer 38

the law, local customs, professional or institutional standards, textbooks, or states

Question 39

What will be taken into consideration when judging your standard of care?

Answer 39

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

Question 40

What are the two situations in which you have a duty to act?

Answer 40

Your EMS’s policy states you must act in any emergency or you have been charged with responding to a specific medical emergency

Question 41

After what point do you have a legal duty to act?

Answer 41

Once your ambulance has responded to a call