Chapter 4: Medical/Legal and Ethical Issues

Question 1

scope of practice

Answer 1

a set of regulation and ethical considerations that define the scope or extent and limits of the EMT’s job

Question 2

consent

Answer 2

permission from the patient for care or other action by the EMT.

Question 3

assault

Answer 3

placing a person in fear of bodily harm.

Question 4

battery

Answer 4

causing bodily harm to or restraining a person.

Question 5

Scope of practice as an EMT

Answer 5

The primary ethical consideration is to make patient care and well-being a priority, even if this requires some personal sacrifice. For example, there may be times when a patient feels cold, even in a hot climate. You may want to turn on the air conditioner in the ambulance, but you refrain out of consideration for your patient

Question 6

Standard of care

Answer 6

defined as the care that would be expected to be provided by an EMT with similar training when caring for a patient in a similar situation.

Question 7

Three types of consent

Answer 7

expressed, implied, and involuntary

Question 8

expressed consent

Answer 8

consent given by adults who are of legal age and mentally competent to make a rational decision in regard to their medical well-being. must be informed consent

Question 9

informed consent

Answer 9

must understand risks associated with care and with declining care

Question 10

implied consent

Answer 10

the consent it is presumed a patient or patient’s parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed

Question 11

Who can give consent?

Answer 11

older than 18; mentally competent

Question 12

in loco parentis

Answer 12

in place of a parent, indicating a person who may give consent for care of a child when the parents are not present or able to give consent

Question 13

When can implied consent be used on children?

Answer 13

in cases of life-threatening illness or injury when a parent or guardian is not present, care may be given based on implied consent.

Question 14

When can minors give consent?

Answer 14

emancipated minors, pregnant minors, military minors

Question 15

involuntary transportation

Answer 15

frequently the result of a decision made by police officers or mental health workers when they believe a patient poses a threat of harm to himself or others. A patient may also be transported against his will as a result of a court order.

Question 16

When a patient refuses care?

Answer 16

legally able to consent; awake and oriented; fully informed; sign a ‘release’ form;

Question 17

consent

Answer 17

permission from the patient for care or other action by the EMT.

Question 18

liability

Answer 18

being held legally responsible

Question 19

Do not resuscitate (DNR)

Answer 19

a legal document, usually signed by the patient and his physician, which states that the patient has a terminal illness and does not wish to prolong life through resuscitative efforts.

Question 20

Advance directive

Answer 20

a DNR order; instructions written in advance of an event.

Question 21

Physician Order for Life-Sustaining Treatment (POLST)

Answer 21

physician orders that state not only the patient’s wishes regarding resuscitation attempts but also the patient’s wishes of artificial feeding, antibiotics, and other life-sustaining care if the person is unable to state his desires later.

Question 22

Negligence

Answer 22

a finding of failure to act properly in a situation in which there was a duty to act, that needed care as would reasonably be expected of the EMT was not provided, and that harm was caused to the patient as a result.

Question 23

what are the four things that must be proven for negligence?

Answer 23

duty, committed a breach of duty, proximal causation, EMT

Question 24

What are most lawsuits against EMTSs?

Answer 24

torts; patient refusal and ambulance collision

Question 25

Tort

Answer 25

a civil, not a criminal, offense; an action or injury caused by negligence from which a lawsuit may arise; uses res ipsa loquitur

Question 26

res ipsa loquitur

Answer 26

“the thing speaks for itself”; it allows a finding of negligence even when there is no specific evidence of a negligent act

Question 27

Duty to Act

Answer 27

An obligation to provide care to a patient

Question 28

Abandonment

Answer 28

leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training

Question 29

Moral

Answer 29

regarding personal standards or principles of right and wrong.

Question 30

Ethical

Answer 30

regarding a social system or social or professional expectations for applying principles of right and wrong

Question 31

Good Samaritan laws

Answer 31

a series of laws, varying in each state, designed to provide limited legal protection for citizens and some health care personnel when they are administering emergency care; These laws do not prevent someone from initiating a lawsuit, nor will they protect the rescuer from being found liable for acts of gross negligence and other violations of the law.

Question 32

Confidentiality

Answer 32

the obligation not to reveal information obtained about a patient except to other health care professionals involved in the patient’s care or under subpoena or in a court of law or when the patient has signed a release of confidentiality

Question 33

When may a patient’s information be shared?

Answer 33

Patient information also may be shared with other health care professionals who will have a role in the patient’s care or in quality improvement. It is appropriate to turn over information about the patient to the nurse and physician at the receiving hospital. This is necessary for continuity in patient care. It may also be necessary and permissible to supply certain patient-care information for insurance billing forms

Question 34

What is HIPPA?

Answer 34

the Health Insurance Portability and Accountability Act, which includes the Privacy Rule protecting the privacy of patient-specific health care information and providing the patient with control over how this information is used and distributed.

Question 35

libel

Answer 35

false injurious information in written form.

Question 36

Slander

Answer 36

false injurious information stated verbally

Question 37

What are medical devices? and what type of conditions are they used for?

Answer 37

necklace, bracelet, or card, heart conditions, allergies, diabetes, epilepsy

Question 38

Organ Donor

Answer 38

a person who has completed a legal document that allows for the donation of organs and tissues in the event of death.

Question 39

Safe haven law

Answer 39

a law that permits a person to drop off an infant or child at a police, fire, or EMS station or to deliver the infant or child to any available public safety personnel. The intent of the law is to protect children who may otherwise be abandoned or harm
○ Vary by state

Question 40

Crime Scene

Answer 40

the location where a crime has been committed or any place that evidence relating to a crime may be found.

Question 41

Providing care at a crime scene

Answer 41

• maintain the condition of the scene
• take note of the patients’ condition
• avoid unnecessary touching
• microscopic evidence
• remember what you touch
• minimize impact on the scene
• work with the police