Chapter Three: Medical, Legal, and Ethical Issues (Emergency Medical Technician)

Vocabulary flashcards covering the core medical, legal, and ethical concepts presented in Chapter Three. Each card presents a key term with a concise definition relevant to EMS practice.

Consent

Permission to treat a patient, typically required from a conscious adult; may be expressed or implied; foundation is the patient’s decision-making capacity and right to refuse.

Expressed consent

Consent given when the patient explicitly acknowledges a desire for care or transport, which may be verbal or nonverbal and must be informed.

Implied consent

Assumed consent when a patient is unconscious or unable to decide, under the emergency doctrine, used only for life-threatening conditions and with reasonable efforts to obtain consent.

Decision making capacity

Ability to understand, process information, and make an informed healthcare decision; not all decisions are medically sound, but the patient has the right to decide.

Patient autonomy

The patient’s right to make decisions about their own health care.

Competence

A legal determination, usually made by a court, about a patient’s ability to make medical decisions; differs from the clinical concept of capacity.

In loco parentis

“In the place of a parent”; school or camp officials may provide consent for a minor when a parent is unavailable, under certain circumstances.

Emancipated minor

A minor who is treated as an adult for certain purposes (e.g., marriage, military service, parenthood, independent living) and may consent to care in some states.

Do Not Resuscitate (DNR)

A physician-ordered directive that instructs not to perform resuscitation; validity and requirements vary by state and setting; does not preclude other compassionate care.

Advance directive

A written document (e.g., living will) outlining treatment preferences for a competent patient who becomes unable to decide.

Living will

A common form of advance directive describing desired treatments and end-of-life preferences.

Health care proxy / Durable power of attorney for health care

A designated surrogate authorized to make health care decisions when the patient cannot; validity depends on state law.

Surrogate decision maker

An individual authorized to make medical decisions for an incapacitated patient when no advance directive or power of attorney is available.

Right to refuse treatment

The legal and ethical right of a conscious, capacitated patient to decline medical care, with documentation and online medical control as needed.

Refusal documentation

Recording the patient’s capacity, assessment findings, provided information, risks, alternatives, and the consequences of refusing care; may involve forms and witness signatures.

Abandonment

Unilateral termination of patient care without transferring to a competent provider, potentially endangering the patient and leading to civil liability.

Assault

Unlawfully placing a person in fear of immediate bodily harm.

Battery

Unlawfully touching a person or providing care without valid consent.

False imprisonment

Unlawful confinement of a person, potentially occurring if a patient is transported against their wishes without proper consent.

Defamation (libel and slander)

False statements that damage a person’s reputation; libel is written, slander is spoken.

Good Samaritan laws

State or common-law protections for individuals who provide care in good faith without expectation of compensation; protections vary and do not cover gross negligence.

Sovereign immunity

A legal doctrine that shields governmental entities and sometimes their employees from liability under certain conditions; not absolute.

Confidentiality

Preservation of patient information and communications within a caring team, protected from unauthorized disclosure.

HIPAA (Health Insurance Portability and Accountability Act)

U.S. law protecting patient privacy and secure handling of protected health information (PHI); establishes minimum necessary disclosure and penalties for violations.

Protected Health Information (PHI)

Any identifying health information related to a patient that must be safeguarded and only disclosed for treatment, payment, or operations.

Scope of practice

The care activities a provider is legally authorized to perform, defined by state law and medical director protocols.

Standard of care

The level and quality of care that a reasonably prudent provider with similar training would give under similar circumstances; influenced by local protocols and laws.

Negligence

Failure to provide the standard of care, requiring four elements: duty, breach, damages, and causation.

Res ipsa loquitur

A tort principle where negligence is inferred from the nature of the injury itself when the provider had control of the situation.

Negligence per se

Liability arising from violating a statute or regulation that defines a standard of care, without needing to prove the exact circumstances of the conduct.

Records and reports

Complete, accurate documentation of patient encounters; essential for safety, quality assurance, legal defense, and QA programs.

National EMS Information System (NEMSIS)

A national database for collecting, storing, and sharing standardized EMS data to improve prehospital care and public health surveillance.

Scene of a crime (EMS considerations)

Do not unnecessarily disturb evidence; coordinate with law enforcement; document positions of patients and objects; preserve the scene.

Death signs (definitive vs presumptive)

Definitive signs include: obvious mortal damage, dependent lividity, rigor mortis, and putrefaction; death definitions often involve absence of circulatory/respiratory function or brain death.

Organ donor

Consent to organ donation, typically indicated by donor cards or registration; treat the patient as a live patient and follow local donor protocols.

Medical identification insignia

Bracelets, necklaces, or cards identifying medical history, allergies, medications, DNR status, and emergency contacts.

Ethics and professional conduct

Applied ethics in EMS; making decisions that balance patient welfare, professional standards, and personal morals; report misconduct and errors.