Chapter 3 Medical, Legal, and Ethical Issues. 3: Medical, Legal, and Ethical Issues 2 Medical, Legal, and Ethical Issues Scope of Practice Defined by

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  • Chapter 3Medical, Legal, and Ethical Issues

    3: Medical, Legal, and Ethical Issues

    Medical, Legal, and Ethical IssuesScope of PracticeDefined by state lawOutlines care you can provide

    3: Medical, Legal, and Ethical Issues

    Standard of CareStandard imposed by local customOften based on locally accepted protocolsProfessional or institutional standardsSpecific rules and procedures of your service or organization

    3: Medical, Legal, and Ethical Issues

    Duty to ActIndividuals responsibility to provide patient care.Responsibility to provide care comes from either statute or function. Legal duty to act begins once a person responds to a call or treatment is initiated.

    3: Medical, Legal, and Ethical Issues

    NegligenceFailure to provide the same care that a person with similar training would provide

    3: Medical, Legal, and Ethical Issues

    Negligence Determination (1 of 2)DutyResponsibility to act reasonably based on standard of careBreech of dutyFailure to act within expected and reasonable standard of care

    3: Medical, Legal, and Ethical Issues

    Negligence Determination (2 of 2)DamagesPhysical or psychological harm created in a noticeable wayCauseExistence of reasonable cause and effect.All 4 must exist for negligence to apply.

    3: Medical, Legal, and Ethical Issues

    AbandonmentTermination of care without patients consentTermination of care without provisions for continued careCare cannot stop unless someone of equal or higher training takes over

    3: Medical, Legal, and Ethical Issues

    ConsentExpressed consentImplied consentMinorsMentally incompetent adults

    3: Medical, Legal, and Ethical Issues

    TO GET PERMISSION, YOU MUST TELL THE VICTIM

    Who you are.Your level of training.What it is you intend to do.

    3: Medical, Legal, and Ethical Issues

    Assault and BatteryAssaultUnlawfully placing a person in fear of immediate bodily harm without consentBatteryUnlawfully touching a person

    3: Medical, Legal, and Ethical Issues

    Refusal of TreatmentMentally competent adults have the right to refuse care.Patients must be informed of risks, benefits, treatments, and alternatives.First Responder should obtain a signature and have a witness present, if possible.

    3: Medical, Legal, and Ethical Issues

    Good Samaritan Laws and ImmunityGood SamaritanBased on the principle that you should not be liable when assisting another in good faithImmunityUsually reserved for governments

    3: Medical, Legal, and Ethical Issues

    Good Samaritan LawsLegal protection exists for people who willingly provide emergency care to ill or injured persons without expecting anything in return.Use common senseUse a reasonable level of skillDo not exceed their scope of trainingAttempt to prevent further injury.

    3: Medical, Legal, and Ethical Issues

    Advance DirectivesSpecifies medical treatments desired if patient is unable to make decisionsDo not resuscitate (DNR) ordersPatients have the right to refuse resuscitative efforts.Require a written order from one or more physiciansWhen in doubt, begin resuscitation.

    3: Medical, Legal, and Ethical Issues

    Ethical Responsibilities

    Make the physical/emotional needs of the patient a priority. Practice/maintain skills to the point of mastery. Critically review performances.Attend continuing education/refresher programs. Be honest in reporting.

    3: Medical, Legal, and Ethical Issues

    ConfidentialityInformation received from or about a patient is considered confidential.Disclosing information without permission is considered a breach of confidentiality.Generally, information can only be disclosed if the patient signs a written release.

    3: Medical, Legal, and Ethical Issues

    Records and ReportsComplete documentation is a safeguard against legal complications.If an action or procedure is not recorded, courts assume it was not performed.An incomplete or untidy report is considered evidence of incomplete or inexpert care.

    3: Medical, Legal, and Ethical Issues

    Special Reporting Requirements (1 of 2) Abuse of children, elderly, and spouseInjury during the commission of a felonyDrug-related injuryChildbirth

    3: Medical, Legal, and Ethical Issues

    Special Reporting Requirements (2 of 2) Infectious disease exposureCrime sceneDeceased

    3: Medical, Legal, and Ethical Issues

    Special SituationsOrgan donorsMedical identification insignia