Ch02
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This document discusses legal and ethical issues that emergency medical responders may face, including their scope of practice, standard of care, duty to act, issues of consent including expressed and implied consent, do not resuscitate orders, negligence, confidentiality including HIPAA requirements, situations that require reporting like abuse or injuries from crimes, and special situations involving organ donors, medical devices, and crime scenes. It also covers the importance of documentation for continued patient care, potential lawsuits, and mandatory reporting requirements.
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Ch02
- 1. Chapter 2 Legal and Ethical Issues
- 6. Consent ► Competence The patient’s ability to understand an Emergency Medical Responder’s questions and the implications of the decisions made. ► Refusal of Care Competent adult patients, or the competent parents or legal guardian of minor patients, can legally refuse emergency care.
- 7. Consent ► Expressed Consent When a patient gives obvious consent to receive emergency care; this can be verbal or non-verbal (such as a nod or simply not pulling away). ► Implied Consent It is implied that a patient would want to receive emergency care if they were aware of the situation and could respond appropriately.
- 8. Do Not Resuscitate (DNR) Order A written, legal document signed by patient and physician explaining that a terminal patient does not want resuscitative efforts. Varying Degrees of DNR: Can specify under which circumstances resuscitation should and should not be initiated for the patient. Click the image to enlarge
- 9. Negligence In order for negligence to occur, four elements must be present: ► Duty to act The Emergency Medical Responder had a legal duty to provide care. ► Breach of duty Care was not provided to an acceptable standard of care. ► Damages The patient was injured in some way as a result of either improper care or the lack thereof. ► Causation There is a direct link between the damages and the breach of duty on the part of the Emergency Medical Responder.
- 14. Special Situations ► Organ Donors ► Medical Identification Devices ► Crime Scenes
Notas del editor
- This is the Title Screen for this lesson.
- Explain that EMS systems are always evolving and that effective EMS professionals never stop looking for ways to improve their skills and knowledge. Encourage them to learn as much as they can about their local EMS system and to see how they can help to improve it.
- Explain that as Emergency Medical Responders, your students are going to be making some very important decisions when responding to medical emergencies. It is critical that each person in the class understands the legal and ethical concepts that go into those decisions in order to provide the best care possible for the patients and to protect themselves and other responders. Briefly highlight these nine areas that you will be explaining in detail during this lesson.
- Explain that as Emergency Medical Responders, your students are going to be making some very important decisions when responding to medical emergencies. It is critical that each person in the class understands the legal and ethical concepts that go into those decisions in order to provide the best care possible for the patients and to protect themselves and other responders. Briefly highlight these nine areas that you will be explaining in detail during this lesson.
- Explain Scope of Practice, Standard of Care and Ethical Responsibilities and ask the class to provide examples of each. Make sure that they understand each concept before moving on.
- After covering all four areas related to consent, give students different scenarios and ask if they represent examples of competence, refusal of care, expressed consent and implied consent. Make sure to ask if a refusal of care can become implied consent and if so, how? (Patient loses consciousness)
- After covering all four areas related to consent, give students different scenarios and ask if they represent examples of competence, refusal of care, expressed consent and implied consent. Make sure to ask if a refusal of care can become implied consent and if so, how? (Patient loses consciousness)
- Once you have introduced DNRs, go into more detail about the specifics that EMRs can run into in the field. For instance, only resuscitate following a witnessed arrest, or respirations only, no chest compressions. Discuss why some patients put limitations on their DNRs.
- Make sure the students understand the four key components of negligence. This would also be a good time to discuss the Good Samaritan Laws in your state and give examples of how they are beneficial to EMRs.
- Discuss confidentiality and why is such an important concept for emergency medical professionals.
- Discuss the reasons for HIPAA's creation and how it benefits patients. Ask how misunderstanding of HIPAA regulations can also, at times, hinder the effectiveness of medical care. Such as when hospital employees misunderstand it and refuse to share important patient care information with those who need it and who can legally access it.
- Explain how Reportable Events work in your area and point out which are, and are not, considered reportable. Ask the class why some situations and injuries are supposed to be reported.
- Explain how Reportable Events work in your area and point out which are, and are not, considered reportable. Ask the class why some situations and injuries are supposed to be reported.
- Stress that patients who are organ donors are NEVER treated differently when it comes to care provided. Pass around some examples of medical identification devices if you have any available. Discuss the basics of entering and providing care at a crime scene. Don’t neglect to explain the importance of not touching anything and not destroying evidence.
- Show examples of PCRs used in your area, explain why good documentation can be so helpful during lawsuits or legal proceedings and talk about the documentation process for mandatory reporting events in your area.