An EMS professional must be prepared to
make the best medical decisions and the most appropriate legal decisions. EMT’s
must be familiar with the legal issues they are likely to encounter in the
field.
Legal duties and ethical
responsibilities.
EMT’s have specific legal duties to their patients, crews, medical directors,
and the public.
Liability/legal responsibilities
include performing patient assessments, provide appropriate medical care, and maintain
accurate and complete of all incidents.
standards are expected behavior and actions of a profession.
Examples are meeting both physical and emotional needs of every patient, treat
all patients with courtesy, maintain mastery of skills, and review your
performance and constantly seek improvement.
standards are expected behaviors and actions as a fellow human
being.
In general there are 5 types of law.
law can be
described as practice that has become the standard.
law is set
by government.
law is the
government versus a citizen.
law is a
dispute between two or more citizens. Another term for this law islaw.
law is
rules of an agency. For example if an EMT renews their certification late a
punitive charge may be added.
Laws affecting EMS and
the EMT
is when a physician allows a lower level skill professional work
under their license and supervision.
is what the EMT has been taught.
describes the acceptable treatment to be provided.
is acknowledgement by an national organization to practice.
is acknowledgment by a local body to practice.
Mandatory reporting
requirements
A of spousal, child, elder and/or sexual abuse must be reported.
Gunshot and wounds along with bites must be reported.
diseases must be reported to the appropriate health department. If
the communicable disease is in nature and the patient is a the information may not be released to the parents.
Legal protections for
the paramedic
laws are intended for the lay public to provide basic care to fellow
citizens without the expectation of charging a fee.
White Act is a tool which may allow an exposed EMS worker to obtain
specific medical history or a patient in case a disease transmission took
place.
Components of a
negligence claim
to act
of duty
Actual
Proximate
All FOUR must be
proven for negligence.
Off-duty EMT
If an off-duty EMT comes upon an MVC
they have a duty to act. If the EMT stops to render aid they
have a duty to render basic care until equal or higher skill level
arrives.
Paramedics have legal and
duties to protect their patients’ privacy and treat them with honesty,
respect, and compassion.
Confidentiality
Situations allowing release of patient
information
As general practice an EMT cannot
release private information without patient for release of records.
Other medical care providers’ need to
know to provide appropriate care.
Legal requirement to release a
patient’s medical records like a or .
Third-party billing requirements
Health Insurance Portability and
Accountability Act which is abbreviated .
Defamation
is false written communication
is false oral communication
Breach of is release of any type of personal private information.
Consent
Informed consent is also known as
, , , and . In all of these cases the patient is given information from cost
of procedure, risks, benefits, and needs then gives a clear indication on
their wishes.
Consent is needed from all competent
adults over the age of .
A&Ox4 stands for
and times 4 questions; , , and .
consent is when the patient is mentally unable to make rational
decisions related to their care.
Involuntary consent is a type of
consent in which the patient is competent but the behavior is
physically endangering their lives. Example; behavioral crisis suicidal.
Special consent
situations
Minor is usually under age
unless they are , legally , , and active .
At any time a competent adult may
withdrawal consent at
during care. The patient may choose only with no care or Care only and no .
Refusal of service at a
minimum requires
Be sure patient is a
adult.
Make multiple and sincere attempts to
convince patient to accept care. Enlist help of others such as
members and friends to convince patient to accept care.
Be certain the patient is fully
about the implications of decision and risks of refusing care.
Advise patient that he may call again for help if needed.
Consult with on-line
direction. Document the entire situation on the patient care report.
Have patient and witnesses
release-from-liability form. The best witness is a
member/spouse or bystander.
Legal complications
related to consent
is not leaving the patient
in the care of a equal or higher skill level.
Assault and battery –
is the threat of unwanted physical contact. is the act of unwanted touching.
False is withholding
freedom of movement to a competent person.
Resuscitation issues. Generally, you are under obligation to
begin resuscitative efforts when summoned to the scene of a patient who is
unresponsive, pulseless, and apneic. Sometimes, however, you will determine that
resuscitation is not indicated.
directives is a generic term used
when a patient expressed their wishes in advance of a medical situation.
provide specification of
the kind of medical treatment a person is willing to accept.
orders indication by
patient of what types of life-sustaining measures will be permitted if heart
and respiratory functions cease.
Potential organ donation.
Death in the field. Crime and accident scenes. You should be familiar with
crime-scene preservation issues, but you must not sacrifice patient care to
preserve evidence or to become involved in detective work.
Contact law enforcement.
Protect yourself and the safety of
other EMS personnel.
Initiate patient contact only when a
crime scene has been deemed safe.
Do not move or touch anything unless it
is necessary for patient care; protect evidence.
If you need to remove items from the
scene, document your actions and notify police.
1. As a paramedic, one of your ethical
responsibilities is to treat all patients with .
2. Your best protection from liability is
to be thorough and perform assessments.
3. The area of law in which the federal,
state, or local government will prosecute an individual on behalf of society for
violating laws meant to protect society is law.
4. Elements of
include proof
that the EMT was the proximate cause of actual damages to the patient.
5. To show the existence of proximate
cause, the plaintiff needs to prove that the to the patient was
reasonably foreseeable.
6. The act of injuring a person’s
character, name, or reputation by false or malicious statements spoken with
malicious intent or reckless disregard for the falsity of those statements is
called .
7. If you respond to a 7-year-old child with
a life-threatening injury and no parent or guardian is available, you may still
treat the child because of consent.
8. If a competent adult refuses care, you
should the situation thoroughly.
9. The termination of the paramedic-patient
relationship without assurance that an equal or greater level of care will
continue is termed .
10. A paramedic who starts an IV on a patient
who does not consent to such treatment may be sued for
.
11. During transport of a patient to a health
care facility, the level of care the patient receives must (may) be at least the
level of
care received at the scene.
12. A document created to ensure that certain
treatment choices are honored when a patient is unconscious or otherwise unable
to express his choice of treatment is called a(n) directive.
13. If you have any doubt about whether a
order is valid, you should initiate resuscitation efforts.
14.
Which type of form gives
instruction to withhold CPR.
15.
When you are treating a
patient at a crime scene, your responsibilities include trying not to touch the
body at all if the patient has an obvious mortal wound such as decapitation.
16.
Regarding documentation the
patient report should be completed after patient contact.
17. A legal document that allows a person to
specify the kinds of medical treatment he wishes to receive should the need
arise is called a living will.
1. The best protection from liability is to
perform assessment, provide appropriate
care, and maintain accurate and complete .
2. The paramedic must treat patients and
their families with and .
3. A civil wrong committed by one individual
against another is called a(n) .
4. The law that is derived from society’s
acceptance of customs and norms over time is called law.
5. is a process used to regulate
occupations.
6. refers to the recognition
granted to an individual who has met predetermined qualifications to participate in a
certain activity.
7. The range of duties and skills paramedics
are allowed and expected to perform is their .
8. You may function as a paramedic only
under the supervision of a licensed physician through a delegation of authority.
12. cause is the action or inaction
of the paramedic that immediately causes or worsens the damage suffered by a patient.
13. is the act of injuring a person’s
character, name, or reputation by false or malicious statements written with malicious intent
or reckless disregard for the falsity of those statements.
14. If your patient is able to make an
informed decision about medical care, he is considered
.
15. Consent for treatment granted by the
authority of a court order is called consent.
16. A person under the age of 18 years who is
married, pregnant, a parent, a member of the armed forces, or financially independent and living
away from home is considered a(n) minor.
17. The unlawful touching of another
individual without his consent is .
18. Intentional and unjustifiable detention
of a person without his consent or other legal authority is called
.
19. Preserve at a crime scene
whenever possible.
20. A well-documented patient report is
completed promptly after
1. Termination of the
EMT-patient
relationship without assurance that an equal or greater level of care will continue.
2. Consent for treatment that is presumed
for a patient who is mentally, physically, or emotionally unable to grant consent.
3. Range of duties and skills paramedics are
allowed and expected to perform.
4. Legal responsibility.
5. A breach of duty by failure to perform a
required act or duty.
6. Exemption from legal liability.
7. An intentional false communication that
injures another person’s reputation or good name.
8. A formal contractual or informal legal
obligation to provide care.
9. The unlawful touching of another
individual without his consent.
10. A civil wrong committed by one individual
against another.
11. A breach of duty by performance of a
wrongful or unlawful act.
12. Provision that gives immunity to certain
people who assist at the scene of a medical emergency.
13. Division of the legal system that deals
with wrongs committed against society or its members.
15. The division of the legal system that
deals with noncriminal issues and conflicts between two or more parties.
16. Deviation from accepted standards of care
recognized by law for the protection of others against the unreasonable risk of harm.
17. The degree of care, skill, and judgment
that would be expected under similar circumstances by a similarly trained,
reasonable paramedic in the same community.
19. The principle of law that prohibits the
release of medical or other personal information about a patient without the patient’s consent.
Think about this:
If an AIDS pt cuts his finger cutting lettuce is it relevant to tell the
emergency room that the patient has AIDS?
Think about this: Is
pt confidentiality violated by labeling the door to a unit “Alzheimer Unit?”
Think about this: A
school nurse calls EMS because a student is having a seizure. The school nurse
gives you a note from the patents that state, “My child has a history of
seizures. Only transport if she does not wake up normally.”
Think about this: A baby sitter calls
911 because the child she is watching is 6 years old and cut her finger with
scissors doing a project. You are getting ready to transport and the parents
come home and state that it is against their religion to accept medical care.
What do you do?
Think about this:
You respond to a MVC of a 16 year old female who has a head laceration is A&Ox4,
6 months pregnant and refuses care. What do you do?