Chapter 4 Medical, Legal, and Ethical Issues

A set of guidelines and legal regulations that define the actions an EMT can perform while providing medical care.

Standards of care refer to what actions are expected of an EMT with similar training in a similar situation. It ensures patients receive the best possible care.

Verbal or non-verbal agreement from a patient to receive medical treatment, assessment, and transport.

If a patient is unconscious or unable to make decisions due to altered mental state, we can assume consent to provide care.

A state of awareness where a person knows who they are, where they are, and what time it is. They can respond to questions and engage in conversation.

The ability of a person to understand and respond to questions about their identity, location, and the current time. This assesses their mental state and level of consciousness.

A legal status granted to a minor who has been deemed capable of making their own decisions and taking care of themselves. This often involves specific legal processes and documentation.

A legal hold that restricts a person's freedom for a limited period, typically 72 hours, to undergo mental health evaluation. It's used when a person is considered dangerous to themselves or others.

A legal document signed by the patient refusing medical care and transportation, acknowledging they understand the potential risks of their decision. It's our documentation of their refusal, proving we met all necessary steps.

Indicators of neurological issues, like slurred speech, difficulty walking, or facial drooping. These situations require immediate care and potentially override the patient's refusal.

A legal term for when a patient is restrained or kept against their will. This applies if we transport them despite their refusal, and it's a very serious offense.

The process of attempting to convince a patient to accept care and transport, even after they initially refuse. It involves clear communication, compassionate listening, and understanding their reasons.

A process of contacting medical control (doctors) over the radio or phone for guidance on how to handle a patient refusal. They might talk to the patient or offer advice on how to proceed.

The final goal in a refusal situation, ensuring the patient receives necessary medical attention, whether by ambulance or a personal vehicle.

A legal term that describes actions that should have been done but were not, or were done incorrectly. It can apply to EMTs not fulfilling their duties or providing substandard care.

A legal concept that implies responsibility to provide assistance or care to a patient based on your professional role as an EMT. This obligation exists while on duty.

A legal term describing a situation where a patient's injuries are so obviously caused by negligence that it is clear the EMT acted improperly.

A legal claim filed against an EMT for their negligence, often seeking financial compensation for damages.

A form intended to confirm a patient's decision to decline resuscitation in the event of a medical emergency. It ensures their wishes are documented and respected.

When a patient refuses medical care, you must ensure they understand the risks and potential consequences. This is documented on a patient refusal form.

A witness is essential when a patient refuses treatment. It could be a family member, friend, or even law enforcement. Avoid using your partner if possible.

If a patient refuses care, document everything thoroughly in your patient care report, including the assessments you performed.

A legal document that allows individuals to express their wishes regarding medical treatment in case they become unable to make those decisions.

A type of Advance Directive that clearly states a patient's wishes to not receive cardiopulmonary resuscitation (CPR) if they stop breathing or their heart stops.

A medical order that outlines the level of life-sustaining treatment a patient wishes to receive in case they become incapacitated, such as artificial ventilation or feeding.

A form that provides clear instructions on what actions to take or avoid during a medical emergency, based on a patient's Advanced Directive.

When in doubt about whether to initiate resuscitation procedures, always err on the side of performing CPR as irreversible brain damage can occur within minutes of circulation stopping.

If you encounter a patient without a pulse and not breathing at home, begin CPR unless they have a DNR. Then, call 911 for assistance with death determination.

A legal process that allows a terminally ill patient to receive medication that helps end their life on their own terms.

The legal process where a patient, meeting specific criteria, refuses medical care and transport. This must be documented with a signed "Refusal of Care" or "Against Medical Advice" (AMA) form.

Contacting medical control (doctors) for advice on how to handle a patient refusal. They may provide guidance, speak to the patient directly, or offer alternative options.

The potential legal consequences of providing unwanted care and transport, including wrongful imprisonment, abduction, and even kidnapping. This emphasizes the importance of obtaining consent before any action.

The legal document signed by a patient who's refusing care, confirming they understand the risks of their decision and acknowledging the EMT's attempts to persuade them. This helps protect the EMT legally.

The legal principle that the injury itself clearly indicates negligence, like a broken bone from a dropped object.

A legal concept where the EMT is sued for their actions or inaction leading to patient harm.

A final document signed by the patient refusing any life-saving treatments, like CPR, if their heart stops.

A legal document signed by a patient refusing medical care and transportation. It acknowledges they understand the potential risks of their decision.

When a patient requests a medication to end their life on their own terms, it's a legal process that requires specific conditions and adherence to local regulations.

LA County EMS policy 815 outlines the steps for responding to patients requesting 'aid in dying' medications. Conscious patients trigger different protocols than unconscious patients.