Chapter 4: Medical/Legal and Ethical Issues Flashcards
scope of practice
a set of regulation and ethical considerations that define the scope or extent and limits of the EMT’s job
consent
permission from the patient for care or other action by the EMT.
assault
placing a person in fear of bodily harm.
battery
causing bodily harm to or restraining a person.
Scope of practice as an EMT
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
Standard of care
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.
Three types of consent
expressed, implied, and involuntary
expressed consent
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
informed consent
must understand risks associated with care and with declining care
implied consent
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
Who can give consent?
older than 18; mentally competent
in loco parentis
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
When can implied consent be used on children?
in cases of life-threatening illness or injury when a parent or guardian is not present, care may be given based on implied consent.
When can minors give consent?
emancipated minors, pregnant minors, military minors
involuntary transportation
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.
When a patient refuses care?
legally able to consent; awake and oriented; fully informed; sign a ‘release’ form;
consent
permission from the patient for care or other action by the EMT.
liability
being held legally responsible
Do not resuscitate (DNR)
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.
Advance directive
a DNR order; instructions written in advance of an event.
Physician Order for Life-Sustaining Treatment (POLST)
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.
Negligence
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.
what are the four things that must be proven for negligence?
duty, committed a breach of duty, proximal causation, EMT
What are most lawsuits against EMTSs?
torts; patient refusal and ambulance collision
Tort
a civil, not a criminal, offense; an action or injury caused by negligence from which a lawsuit may arise; uses res ipsa loquitur
res ipsa loquitur
“the thing speaks for itself”; it allows a finding of negligence even when there is no specific evidence of a negligent act
Duty to Act
An obligation to provide care to a patient
Abandonment
leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training
Moral
regarding personal standards or principles of right and wrong.
Ethical
regarding a social system or social or professional expectations for applying principles of right and wrong
Good Samaritan laws
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.
Confidentiality
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
When may a patient’s information be shared?
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
What is HIPPA?
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.
libel
false injurious information in written form.
Slander
false injurious information stated verbally
What are medical devices? and what type of conditions are they used for?
necklace, bracelet, or card, heart conditions, allergies, diabetes, epilepsy
Organ Donor
a person who has completed a legal document that allows for the donation of organs and tissues in the event of death.
Safe haven law
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
Crime Scene
the location where a crime has been committed or any place that evidence relating to a crime may be found.
Providing care at a crime scene
- 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
