Chapter 7 Medical-Legal Aspects of Out-of-Hospital Care

Define Constitutional Law?

Based on the Constitution of the United States, basic give structures and protects people against governmental abuse

Define Common Law

Referred to as “case law” or “judge-made law”, originated with the English legal system and was adopted by Americans in the 1700s. Common law changes and grows over the years

Define Legislative Law

also known as statutory law, it is created by lawmaking or legislative bodies (U.S. congress, state assemblies, cities, schools)

Define Administrative Law

also know as regulatory law, is enacted by an administrative or governmental agency at either the federal or state level. example… OSHA

Define Criminal Law

deals with crime and punishment. area of law in which the federal, state, or local government prosecutes an individual on behalf of society for violating laws that are meant to protect.

Define civil law

non-criminal issues like personal injury, contract disputes and matrimonial issues

Define tort law

branch of civil law, deals with civil wrongs committed by one individual against another. includes negligence, medical malpractice, assault and battery.

The range of duties and skills that EMS practitioners are allowed and expected to perform is called what

scope of practice.

who sets scope of practice?

usually set by state law or regulation and/or by local medical directon

Define immunity

exemption from legal liability, is another form of protection

What is the Good Samaritan Law?

provides immunity to people who assist at the scene of a medical emergency. All acts in good faith

Most civil claims against EMS providers center in negligence but some are based on intentional tort. What is intentional tort?

civil wrong committed by one person against another based on willful act

Define negligence

deviation from accepted standards of care recognized by law for the protection of others against the unreasonable risk of harm

4 elements of negligence

duty of act, breach of that duty, actual damage and proximate cause

Define duty of act

clinician had a formal contractual or informal legal obligation to provide care. examples would be to respond to the scene and render care to ill or injured patients, to provide care and transportation to the expected standard of care, etc

3 types of breach of duty

malfeasance, misfeasance and nonfeasance

what does malfeasance mean?

the performance of wrongful or unlawful act by the EMS practitioner. example… practitioner who assaults a patient commits malfeasance

define misfeasance

performance of a legal act in a manner that is harmful or injurious. example… an EMS practitioner who intubates a patient but fails to confirm tube placement/breath sounds/etc and leaves the tube.

define nonfeasance

failure to perform a requires act or duty. example… NOt helping your patient at all

What is borrowed servant doctrine?

because you are the medic (highest trained person), it is your responsibility to make sure they perform their duties in a professional and medically appropriate manner. you (as the medic) are responsible for EVERYTHING that happens to the patient

Define consent

granting of permission to treat/touch the patient

difference between capacity and competence

capacity is a medical judgement while competence is a legal judgement made by a court or judge

define informed consent

patient must understand the nature, risk and benefits of any procedures to be performed. example would be wanting to CPAP a patient, pt must understand the risk, benefits and alternatives of the CPAP before making a decision (you are INFORMING them)

define expressed consent

when a person directly grants permission to treat- verbally, nonverbally or written. you must get consent for every action you do. examples would be telling the patient “I would like to start an IV for fluids because your pressure is low.” pt can refused treatment or agree to the IV

define implied consent

assumed that if such a pt were able to give informed consent, that pt would want life saving treatment. example… unconscious person found on the sidewalk. assume the patient would want you to do treatment

define involuntary consent

a court will order pt to undergo treatment even though they may not want it. examples… ED/ID or mental writ

define abandonment

termination of care from an EMS practitioner and a patient but the patient still need/desire care

define assault

unlawfully placing a person in apprehension of immediate bodily harm without consent

define battery

unlawful touching of another individual without consent

whats the difference between assault and battery

assault involves placing a person in fear or unwanted, immediate harm while battery is actually touching the person causing harm

define reasonable force

minimum amount of force necessary to ensure that the pt does not cause injury to themselves, yourself or any one else

documentation always must remain blank

objective

the blank is the location of mot of the cases in which a paramedic may become involved

state court system

on-scene licensed physician who are professionally unrelated to the patient and who are attempting to assist with patient are called blank

intervener physicians

if an intervener physician tries to step in and help, what are they required to do?

ride in to the hospital and complete the chart

the law provides penalties for the breach of confidentiality. the improper release of information may result in a lawsuit against the paramedic for

defamation, invasion of privacy and breach of confidentiality

a well-document patient care report is

accurate, objective and thorough

example of nonfeasance

just NOt doing your job all together, NOt helping your patient when they need help

example of MISfeasance

a MIStake… placing an ET tube in a patient and not checking chest rise and fall, eoigastric sounds, lung sounds, etc

example of MALFeasance

think MALFory from harry potter… intentionally causing harm, they knew it was wrong and did it anyways example… performing a chest tube, not in our scope of practice… knew it was wrong and did it anyways