Chapter 3 Knowledge objectives: Medical, Legal, and Ethical Issues

Define consent, and describe how it relates to decision making. Ch.3 #1 Pg.79-80

consent is permission to render care. The foundation of consent is decision making capacity, which is the ability of a patient to understand the information you are providing to him or her, coupled with the ability to process the information to make an informed choice regarding medical care that is appropriate for him or her.

Differentiate expressed consent, implied consent, and involuntary consent. Ch.3 #2 Pg.80-81

expressed consent or actual consent is consent given verbally or they can otherwise that they want treatment or transportation, implied consent is a type of consent in which a patient who is unable to give consent id given treatment under the legal assumption that he or she would want treatment and involuntary consent is consent given Consent granted by the court. Common for patients who are held for mental health evaluation, or patients by law enforcement who are in protective custody. Also, used on patient who have disease which treatens a community at large

Discuss the giving of consent by minors for treatment or transport. Ch.3 #3 Pg.81

Minors can not give their own consent it must be done by a parent or gaurdian, unless however they are an emancipated minor, in which case the court has grated them adult rights, if a minor is under care of a school or camp those officials have the right to grate consent, which is known as in loco parentis

Describe local EMS system protocols for using forcible restraint. Ch.3 #4 Pg.81-82

forcible restraint is sometimes necessary when dealing with a combative patient that is at risk of harming themselves or others. It is recommended to contact medical control prior to restraint of a patient most states require a law officer or another authorized official to be present during the process. If all else fails be sure you have a witness available.

Discuss the EMT's role and obligations if a patient refuses treatment or transport Ch.3 #5 Pg.82-83

it is a competent patient's right to refuse treatment. If a patient refuses treatment or transportation the EMT must 1st involve medical control and note the patients decision and why on your report. The patient will need to sign a refusal form and have a witness signature, if and only if no witnesses are available your partner may sign the form. Finally prior to leaving the scene the EMT must try and explain treatment again to get the patient to agree to care

Understand that communication with patients is confidential and protected by the Health Insurance Portability and Accountability Act. Ch.3 #6 Pg.83-84

Considers all patient information that you obtain in the course of providing medical treatment to a patient to be Protected Health information (PHI)

Discuss the importance of do not resuscitate (DNR) orders (advanced directives) and provisions in the locality regarding EMS application. Ch.3 #7 Pg.84-85

If you arrive on scene and a valid written document can not be provided you must begin care until it can be produced or medical control gives you permission to stop. A competent patient can ask you to stop and if they become incompetent and have an advanced directive that specifies treatment and non treatments you can stop.

Describe the physical, presumptive, and definitive signs of death. Ch.3 #8 Pg.85-87

Physical signs of death are to be determined by a physician, presumptive signs of death are: unresponsive to painful stimuli, lack of a carotid pulse or heartbeat, absence of breath sounds, no deep tendon or corneal reflexes, absence of eye movement, no systolic blood pressure, profound cyanosis, and lowered or decreased body temperature. definitive signs of death: decapitation, dependent lividity, rigor mortis, decomposition of the body.

Understand that organ donors are treated the same way as other patients needing treatment and that local protocols are followed with such patients. Ch.3 #9 Pg.87

when a patient is an organ donor we still want to keep them alive, the tissues need to have O2 to survive.

Recognize the importance of medical identification insignia in treating the patient. Ch.3 #10 Pg.87

read this thoroughly they will have pertinent treatment info on them

Understand the scope of practice and standards of care. Ch.3 #11 Pg.87-90

scope of practice is the state determined care you are able to provide to a patient, standards of care is the manner in which you act or behave to prevent further harm to a patient

Describe the EMT's legal duty to act Ch.3 #12 Pg.90

An EMT's legal duty to act is an individuals responsibility to provide patient care.

Discuss the issues of negligence , abandonment , assault and battery, and kidnapping and their implications for the EMT. Ch.3 #13 Pg.90-92

all of these can put an EMT in the courts, negligence is when you fail to provide the same care that a person with the same or similar training would provide in the same or similar situation, abandonment is when then EMT terminates care without transfer to an individual with equal or great training, assault is when you unlawfully place a person in fear of bodily harm, battery is unlawfully touching someone and kidnapping is when you seize, confine, abduct or carry a patient away against their will.

Explain the reporting requirements for special situations, including abuse, drug or felony-related injuries, childbirth, and crime scenes. Ch.3 #14 Pg.93-95

you must report it.

Define ethics and morality, and discuss their implications for the EMT. Ch.3 #15 Pg.95-96

ethics are the philosophy of right and wrong, morality is the code of conduct determined by society. Be aware of who and where you are treating a patient, you must respect their culture.

Understand the role and comportment of the EMT in court. Ch.3 #16 Pg.96-97

You can be either a 1.witness or 2. defendant Whenever you are subpoenaed to testify in any court proceeding, you should immediately notify 1. Your service director

2. Legal counsel