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
