LectureOUTLINE_CH03 Medical, Ethical, and Legal Issues

75 Question-and-Answer flashcards covering key medical, legal, and ethical concepts for EMTs, based on Emergency Care and Transportation of the Sick and Injured, 12th Edition, Chapter 3.

What is the definition of consent in the EMS setting?

Permission granted by the patient for the EMT to render care or transport.

What is expressed consent?

Consent that is given verbally or otherwise affirmatively by a patient who wants care.

What additional requirement makes expressed consent valid?

The patient must receive informed consent—an explanation of the nature, risks, benefits, and alternatives of treatment.

What is implied consent?

Consent assumed for an unresponsive or incapacitated patient when a serious threat to life or limb exists.

When is implied consent typically used?

Only in true emergencies when the patient cannot make decisions and delaying care would endanger life or limb.

What is involuntary consent?

Consent obtained for treatment of patients who are mentally ill, developmentally delayed, or in behavioral crisis, often via a legal guardian or law-enforcement authority.

Which patient groups often require involuntary consent?

Mentally ill individuals, those in psychological crisis, and developmentally delayed persons.

Who normally provides consent for a minor?

The minor’s parent or legal guardian.

What is an emancipated minor?

A person younger than the legal age who is treated as an adult because of marriage, military service, parenthood, or court order.

What does in loco parentis mean?

Teachers or school officials acting in place of parents and able to give consent for a minor’s care in school or camp settings.

In a true emergency with no guardian available, how may a minor be treated?

Under implied consent.

What is forcible restraint?

Physically or chemically restraining a patient who poses a danger to self or others and requires medical care or transport.

Before using forcible restraint, what should an EMT do?

Consult medical control and involve law enforcement per local protocols.

Once restraints are applied, when may they be removed en route?

Only if they endanger the patient; otherwise leave them in place until higher medical authority assumes care.

What right does a competent adult have regarding treatment?

The right to refuse treatment or transport, even if it may result in death or serious injury.

List the five key points an EMT should discuss when a patient considers refusing care.

Assessment findings, proposed treatment, risks of treatment, alternatives, and potential consequences of refusal.

Why should online medical control be contacted during a refusal?

To validate the refusal process and provide additional documentation support.

What form should a patient sign when refusing treatment?

A refusal of treatment/transport form, witnessed and documented by the EMT.

What legal concept protects private patient information?

Confidentiality.

What does HIPAA stand for?

Health Insurance Portability and Accountability Act.

What is Protected Health Information (PHI)?

Any medical or identifying data obtained while providing care that is protected under HIPAA.

Give one situation in which patient records may be released without a subpoena.

When the patient signs a written release (other acceptable answers: billing necessity, mandated reporting).

What general guideline should EMTs remember about social media use?

Maintain the same professionalism online as on duty and avoid posting identifiable patient information.

What does the abbreviation DNR represent?

Do Not Resuscitate order.

Does a DNR order equal "do not treat"?

No; supportive measures such as oxygen and pain relief should still be provided if the patient is not in cardiac arrest.

What is an advance directive?

A written document that specifies a competent patient’s wishes for medical treatment if they become unable to decide.

State one requirement of a valid written DNR order.

It must include a clear statement of the medical problem, patient or guardian signature, and physician signature (plus be dated within the last 12 months if expiration applies).

What are POLST and MOLST forms?

Physician/Medical Orders for Life-Sustaining Treatment that specify acceptable interventions for seriously ill patients.

What is another name for a durable power of attorney for health care?

Health care proxy.

Name two presumptive signs of death.

Examples: unresponsiveness to pain; absence of carotid pulse; no chest rise; absent reflexes; no pupillary response; no systolic BP; profound cyanosis; low body temperature.

Give one definitive sign of death.

Obvious mortal injury (e.g., decapitation), dependent lividity, rigor mortis, algor mortis, or putrefaction.

What physiological process causes rigor mortis?

Chemical changes that stiffen muscle tissue 2–12 hours after death.

Who is generally notified for deaths without obvious natural causes?

The medical examiner or coroner.

What is the EMT’s primary priority when treating a registered organ donor?

Preserve the patient’s life and provide high-quality care; organs require oxygen until surgical recovery.

Where might an EMT locate patient medical alerts?

Bracelets, necklaces, keychains, wallet cards, or USB devices labeled as medical identification.

Define scope of practice.

The range of patient care activities an EMT is legally allowed to perform, usually set by state law.

Who authorizes EMT care via protocols?

The service’s medical director.

What are online medical direction orders?

Real-time instructions received from a physician by phone or radio.

Define standard of care.

The manner an EMT with similar training would act in similar circumstances.

Give one common source that establishes a standard of care.

Local customs, state laws, professional guidelines, textbooks/NHTSA curriculum, or agency protocols.

What is duty to act?

An individual’s legal obligation to provide patient care once a response begins or treatment is initiated.

When does an EMT usually have a legal duty to act?

When responding on duty to an assigned call or once patient care has started.

Define negligence.

Failure to provide the standard of care that another similarly trained person would have provided, causing harm.

Name the four elements required to prove negligence.

Duty, breach of duty, damages, and causation.

What does res ipsa loquitur mean in negligence cases?

"The thing speaks for itself"—the injury would not occur without negligence under the EMT’s control.

What is negligence per se?

An act considered negligent because it violates a statute (e.g., performing an ALS skill beyond scope).

What is a tort?

A civil wrong, such as defamation or invasion of privacy, actionable in civil court.

Define abandonment in EMS.

Unilateral termination of care without patient consent and without ensuring equal or higher level care continues.

What should an EMT obtain at hospital transfer to avoid abandonment claims?

A signature on the patient care record from the accepting provider.

What is assault in the EMS context?

Putting someone in fear of immediate bodily harm, such as threatening unwarranted restraint.

What constitutes battery by an EMT?

Unauthorized touching, including providing care without consent.

How might kidnapping occur in EMS?

Transporting a patient against their will without lawful authority.

What is false imprisonment?

Unauthorized confinement of a person, such as restraining without proper legal basis.

Define defamation.

Communication of false information that harms someone’s reputation.

Differentiate libel and slander.

Libel is written defamation; slander is spoken defamation.

State one requirement for Good Samaritan law protection.

Acted in good faith, expected no compensation, stayed within scope, and did not act with gross negligence.

What is gross negligence?

Willful or reckless disregard for accepted standard of care.

What documentation principle do courts use regarding EMS reports?

If it wasn’t written, it wasn’t done; incomplete reports imply poor care.

What does NEMSIS stand for or provide?

National EMS Information System—standardized collection and sharing of EMS data nationwide.

List two situations EMTs are commonly mandated to report.

Examples: child abuse, elder abuse, drug-related injuries, felony injuries, childbirth, dog bites, certain communicable diseases, sexual assault, violent crime scenes, deaths, or patients in restraints.

Define ethics in EMS.

The philosophy of right and wrong and the ideal standards of professional behavior.

Define morality.

A personal or societal code of conduct affecting character and conscience.

What is bioethics?

Ethical issues specifically related to health-care practice.

What is applied ethics?

Putting ethical principles into professional action and decision making.

When subpoenaed, whom should an EMT notify first?

The service director and the organization’s legal counsel.

Name one legal defense available to an EMT in court.

Statute of limitations, governmental (sovereign) immunity, or contributory negligence.

What is discovery in a lawsuit?

Pre-trial phase where both sides gather information to understand the case fully.

Give two common discovery tools.

Interrogatories (written questions) and depositions (oral testimony under oath).

Define compensatory damages.

Monetary awards intended to reimburse the plaintiff for actual injuries or losses.

Define punitive damages.

Monetary awards intended to punish and deter particularly reckless or intentional misconduct.

What is contributory negligence?

A defense claiming the plaintiff’s own actions contributed to the injury or damages.

What is sovereign (governmental) immunity?

Legal protection limiting or preventing lawsuits against governmental EMS agencies.

What is algor mortis?

The post-mortem cooling of the body until it reaches ambient temperature.

What is dependent lividity?

Blood pooling to the lowest part of the body after death, causing skin discoloration.

What is the emergency doctrine?

The principle that allows care under implied consent during life-threatening emergencies when consent cannot be obtained.