Medical, Legal, & Ethical Issues Flashcards
A basic medical, legal, and ethical principle of emergency care is to first ___
Do no further harm
EMTs are better positioned to avoid professional legal problems when they ___
Act in good faith, follow an appropriate standard of care, and provide compassionate care
Immediate care or treatment
Emergency medical care
Typically, ___ is required from every conscious adult before care can be started
Consent
An adult who is ___ has the legal right to refuse care
Conscious, rational, and capable of making informed decisions
Consent can be expressed or ___
Implied
The foundation of consent is ___
Decision-making capacity
The ability of a patient to understand the information you are providing, coupled with the ability to process that information and make an informed choice regarding medical care
Decision-making capacity
The right of a patient to make decisions concerning their health
Patient autonomy
Generally regarded as a legal term and determinations regarding it are made by a court of law
Competence
The term more commonly used in health care to determine whether or not a patient is capable of making health care decisions
Decision-making competence
Factors to be considered when determining a patient’s decision-making competence
- Mental limitation/dementia
- Are they of legal age?
- Impaired by alcohol, drugs, or serious injury/illness
- Experiencing significant pain
- Have a significant injury that could distract from a more serious injury
- Hearing or visual problems
- Language barrier
- Do they understand you/ask rational questions?
The type of consent given when the patient specifically acknowledges that they want you to provide care or transport
Expressed consent
Expressed consent is also called ___
Actual consent
Expressed consent may be ___
Verbal or nonverbal
To be valid, the consent the patient provides must be ___
Informed consent
You explained the nature of the treatment being offered, along with the potential risks, benefits, and alternatives to treatment, as well as potential consequences of refusing treatment
Informed consent
Always document consent in your ___
Run report
A patient may agree to certain types of emergency medical care but ___
Not to others
When a person is unconscious or otherwise incapable of making a rational, informed decision about care and unable to give consent, the law assumes that the patient would consent to care and transport to a medical facility if they were able to do so
Implied consent
Implied consent applies only when ___
A serious medical condition exists and should never be used unless there is a threat to life or limb
The principle of implied consent is known at the ___
Emergency doctrine
Relating to medical jurisprudence or forensic medicine
Medicolegal
In most instances, the law allows a ___ to give consent for an injured person who is unable to do so
Spouse, a close relative, or next of kin
If a patient is being treated based on implied consent and regains consciousness and appear capable of making an informed decision, the doctrine of implied consent ___
Would no longer apply
Under certain circumstances ___ are legally permitted to give consent for any individual who is incarcerated or has been placed under arrest
LE and prison officials
A prisoner who is conscious and capable of making decisions may ___
Refuse care
Involuntary consent is similar to ___ and consent should be obtained from ___
- Those involving minors
- Someone legally responsible for the patient, such as a guardian or conservator
Minors require a ___ to give consent for treatment and transport
Parent or legal guardian
In every state, when a parent cannot be reached to provide consent, health care providers are allowed to ___
Give emergency care to a child
In some states, a minor can consent to receive medical care, depending on ___
The minor’s age and maturity
People who, despite being under the legal age in a given state, can be legally treated as adults based on certain circumstances
Emancipated minors
Many states consider minors to be emancipated if they are ___
Married, members of the armed forces, or if they are parents
Also if they are living away from and no longer relying on their parents for support
A minor who is a parent may also give consent for ___
Their own child
If a minor is injured and requires medical treatment in a school or camp setting, teachers and school officials may act ___
In loco parentis
In the position or place of a parent, and can legally give consent for treatment of the minor if the parent or guardian is not available
In loco parentis
Even if acting in loco parentis, you should still attempt to ___
Obtain consent from a parent or legal guardian whenever possible
If a parent or legal guardian is not present and a true emergency exists, the consent to treat the minor is ___
Implied
___ is sometimes necessary when you are confronted with a patient who is in need of medical treatment and transportation but is combative and presents a significant physical risk of danger to themselves or others
Forcible restraint
Typically you should consult ___ for authorization to restrain or ___
- Medical control
- Contact LE personnel who have the authority to restrain people
___ should always be attempted prior to considering physical restraints
Verbal de-escalation
After restraints are applied, they should not be removed en route unless ___
They pose a risk to the patient, even if the patient promises to behave
While restrained, it is essential that you ___
Protect the patient’s airway and monitor the patient’s respiratory and circulatory status to avoid asphyxia, aspiration, and other complications
Consider calling for ALS backup to provide ___, as this may be safer than physical restraint, depending upon the situation
Pharmacologic restraint
Adults who are ___ have the right to refuse treatment or withdraw from treatment at any time
Conscious, alert, and appear to have decision-making capacity
Calls involving refusal of treatment pose a risk of ___
Litigation
In all such cases of refusal of treatment, you should involve ___
Online medical control and document this consultation
What information should be given to the patient to guide their decision to accept or refuse care?
- What might be wrong with the patient
- Description of the treatment believed necessary
- Possible risks of treatment
- Availability of alternative treatments
- Possible consequences of refusing treatment
PCR
Patient Care Report
When treatment is refused, you must assess the patient’s ability to make an ___
Informed decision
Patients who have attempted or conveyed ___ intent should not be regarded as having normal mental capacity
Suicidal
When in doubt, providing treatment is usually a much more ___ than failing to treat a patient
Defensible position
Before leaving the scene where a patient has refused care, you should again encourage the patient up to ___ times if the situation allows, to permit treatment
3
Do what before leaving a patient who has refused care?
- Encourage them to change their mind
- Remind them to call 911 if it changes or gets worse
- Advise them to see their personal physician ASAP
- Have them sign a refusal of treatment form (signature should be witnessed by a family member or police officer)
- Notify medical control
Who must sign the refusal of care for for a child?
The individual who is refusing treatment
Communication between you and the patient is considered ___
Confidential
Disclosure of confidential information to anyone other than those providers directly involved in the care of the patient without proper authorization may result in liability for ___
Breach of confidentiality
Patient information may also be shared with ___
Third-party billing personnel
HIPAA considers all patient information that you obtain in the course of providing medical treatment to a patient to be ___
Protected health information
PHI
Protected health information
PHI includes not only medical information, but also any information that can ___
Be used to identify the patient
As an EMT, you have an obligation to guard all PHI from ___
Unlawful disclosure, either written or verbal
