HOSA Bowl - Legal and Ethical

abandonment

leaving a patient after care has been initiated and before the patient has been transferred to someone with equal or greater medical training

advance directive

a DNR order; instructions written in advance of event

assualt

placing a person in fear of bodily harm

battery

causing bodily harm to or restraining a person

confidentiality

the obligation not to reveal information obtained about a patient except to other health care professionals involved in the patient's care, or under subpoena, or in a court of law, or when the patient has signed a release of confidentiality.

consent

permission from the patient for care or other action by the EMT

crime scene

the location where a crime has been committed or any place the evidence relating to a crime may be found

Priority is patient care.

Know what evidence is & take steps to preserve it.

do not resuscitate order (DNR)

a legal document, usually signed be the patient and his physician, which states that the patient has a terminal illness and does not wish to prolong life through resuscitative efforts.

duty to act

an obligation to provide care to a patient.

On Duty- obligated to provide care if no threat to safety

Off Duty/ On duty & out of jurisdiction- Not clear

ethical

regarding a social system or social or professional expectations for applying principles of right and wrong

expressed consent

consent given by adults who are of legal age and mentally competent to make a rational decision in regard to the medical well-being.

Good Samaritan laws

a series of laws, varying in each state, designed to provide limited legal protection for citizens and some health care personnel when they are administering emergency care in good faith within level of training. Rarely applies to on-duty personnel. Does NOT protect from gross negligence or violations of law

HIPAA

Health Insurance Portability and Accountability Act, a federal law protecting the privacy if patient-specific health care information and providing the patient with control over how this information is used and distributed

Scope of Practice

Regulations and ethical considerations that define extent of limits of job duties

"What you can do"

Standard of Care

Care expected from EMT with similar training for patient in a similar situation. Lowers risk of legal action. "How you should do it"

Ethics

Morals or standards governing actions. VERY important in EMS. "what would you do when no one is looking?"

Patient Consent

Permission to assess, treat, and transport

Implied Consent

Assumed consent, Follow local law and protocols

Consent for Children

If minor, obtain consent from parent or legal guardian. Exceptions: In loco parentis, emancipated minors, life-threatening injury or illness, minors who have children, minors serving in armed forces

Consent from Mentally Incompetent Adults

Incapable of being considered informed. State and local laws and protocols permit transport of such patients under implied consent

Involuntary Transportation

Patient considered threat to self or others, court ordered, usually requires decision by mental health professional or police officer. Must not risk legal liability if restrained

Refusal of Care

Patient may refuse care or transport if:

-legally able to consent

-mentally competent and oriented

-fully informed of risks

-signs release form

Despite all precautions, EMT may still be held liable. IF in doubt of refusal, call family member, authorities, and discuss further with patient.

Have witnesses to refusal. Document, document, document!

Advanced Directives

Legal document expressing patient's wishes if patient unable to speak. Examples: DNR, Living Will, Health care proxy.

Note: Does not prevent EMT from providing comfort measures.

You arrive on the scene of a patient in cardiac arrest. The family says she has a DNR, but don't know where it is. How should you handle this?

If there is no documentation indicating the patient's wishes not to be resuscitated, most department policies state that the EMT should begin resuscitation. If the document is later produced, efforts may be terminated (usually after consulting with medical control). Remember, you can always stop later after you start, but you can't start later and have much chance of success.

Organ Donor

Persona with completed legal document allowing donation of organs and tissue in event of death. Could be identified by family, DL, donor card

Safe Haven LAws

Allows person to drop an infant or child at any fire, police, or EMS station.

Examples of Evidence

Condition of Scene, Patient, Fingerprints, footprints, microscopic evidence

Evidence Preservation

-Remember what you touch.

-minimize impact on scene

-work with police

-stretcher sheet may be valuable

-document thoroughly

Mandatory reporting

-Child, elderly, or domestic avuse

-sexual assault

-stab/gunshot wound

-animal attacks

What steps must you take when a patient refuses care or transportation?

When a patient refuses care or transportation, make sure that all aspects of the refusal are documented, including all of the steps taken to persuade the patient to be treated and transported. Tell patient that he can call again if the condition worsens. Suggest that someone stay with the patient.

What is a threat or attempt to injure ?

Assault

If a nurse assistant forgets to raise the siderails on the bed and the patient falls out of bed , the nurse assistant might be guilty of :

Negligence

if a physician fails to use the degree of skill and learning commonly expected in that individuals profession , the physician could be guilty of :

Malpractice

A person who is under the influence of drugs does not have the legal capacity to from a contract because he/she has a :

Legal Disability

If a laboratory technician sends e-mails to co-workers saying that a particular physician is careless. and killed a patient , the lab tech might be guilty of.

Libel

What term describes the fact that information about A patient must remain private ?

Confidentiality

Before you perform any procedure on a patient , You must have proper .

Authorization

What does the acronym PSDA stand for ?

Patient Self-Determination Act

What should you do if you are a health care worker and you make a mistake ?

Report it immediately to your supervisor

When can a health care worker accept a tip or bribe?

Never

What term describes a standard code of conduct for health Professionals ?

Ethics or ethical code

A nurse is helping a patient walk and jerks the patient by the arm , causing a bruise the nurse may be guilty of :

Battery

What is permission granted voluntarily by person who is of sound mind after the procedure has been explained in terms the person can understand ?

Informed Consent

if a health care worker makes false statements about a patient that causes the patient to be damaged or ridiculed , the health care worker may be guilty of :

Defamation (could accept slander)

Speaking harshly , swearing or shouting and using inappropriate words to describe a persons nationally are all examples of what kind of abuse ?

Verbal

What kind of contract exists when a nurse is holding a thermometer under his or her tongue ?

Implied contract

What do the initials HIPAA stand for ?

Health insurance portability and accountability act

if I have the legal capacity to sign a consent from, I must be :

18-years-old and mentally competent (free of legal disability)

what patients rights document applies to persons in long-term care facilities ?

Residents bill of rights

A Document a person signs to indicate he/she does not want to be resuscitated when he/she stops breathing is a :

Living Will

Health care records are examples of :

privileged communications

what federal standards provide for the privacy of health information in all states ?

HIPAA

What is an example of physical abuse ?

Hitting .forcing people against their will , ETC

Keeping someone in the hospital against their will could be an example of :

False Imprisonment