Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Chapter 2

Legal and Ethical Issues

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Retro Review

Chapter 1: Introduction to EMS Systems

► Components of the EMS System► The Emergency Medical Responder

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Introduction

► Legal Duties► Consent► Do Not Resuscitate (DNR) Orders► Negligence► Abandonment

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Introduction

► Confidentiality► Reportable Events► Special Situations► Documentation

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Legal Duties► Scope of Practice Care and procedures allowed by law for individuals trained to or licensed at

a particular level.

► Standard of CareWhat is generally expected of individuals trained to or licensed at a particular level.

► Ethical ResponsibilitiesBehavioral expectations placed on individuals trained to or licensed at a particular level.

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Consent► Competence

The patient’s ability to understand an Emergency Medical Responder’s questions and the implications of the decisions made.

► Refusal of CareCompetent adult patients, or the competent parents or legal guardian of minor patients, can legally refuse emergency care.

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

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 ConsentIt is implied that a patient would want to receive emergency care if they were aware of the situation and could respond appropriately.

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

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

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

NegligenceIn order for negligence to occur, four elements must be present:

► Duty to actThe Emergency Medical Responder had a legal duty to provide care.

► Breach of dutyCare was not provided to an acceptable standard of care.

► DamagesThe patient was injured in some way as a result of either improper care or the lack thereof.

► CausationThere is a direct link between the damages and the breach of duty on the part of the Emergency Medical Responder.

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

ConfidentialityEmergency Medical Responders should not speak to friends, family, or other members of the public (including the media) about patients or the care provided during an emergency including:

► Patient names

► Specifics of the event

► Unusual behavior observed or personal descriptions of the patient

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Confidentiality

HIPAAHealth Insurance Portability and Accountability Act

► Established rules about how patient medical information can be stored and shared.

► Established strong accountability for the use and sharing of patient information.

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Reportable EventsEvents that Emergency Medical Responders must

usually report to appropriate authorities:

► Exposure to infectious diseases

► Suspicious burns

► Vehicle crashes

► Drug-related injuries

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Reportable EventsEvents that Emergency Medical Responders must

usually report to appropriate authorities:

► Knife or gunshot wounds

► Child or elder abuse

► Domestic violence

► Rape

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Special Situations

► Organ Donors

► Medical Identification Devices

► Crime Scenes

Bergeron, First Responder 8th ed. © 2009 by Pearson Education, Inc. Upper Saddle River, NJ

Documentation

Reasons to Document Care:

► Continued Patient Care

► Lawsuits

► Mandatory Reporting Situations