Law and Ethics Final 3 - AQA Past Paper PDF

**Chapter 1.1:** What is a law? - A set of rules and regulations that govern the relationships between individuals and organizations. Why do we need law? - It helps people understand their duty to know what is expected from them and what they expect in others in return. - It helps...

**Chapter 1.1:** What is a law? - A set of rules and regulations that govern the relationships between individuals and organizations. Why do we need law? - It helps people understand their duty to know what is expected from them and what they expect in others in return. - It helps control behavior that could threaten public safety. - To keep society functioning efficiently. Why is it important for the paramedic to understand law? - To know their rights and responsibilities - To know how to get out of legal entanglements. - It protects the paramedics, patients, co-workers etc. - It ensures paramedics' ethical behavior with patients and workplace. Areas of law: - General Law 1. Constitutional law 2. Administrative law 3. Criminal law - Private Law: Organizes the rights and duties between private individuals and organizations. 1. Civil Law Criminal and civil laws are most likely to pertain to healthcare practitioners. General Law: Governs the powers of the government and public authorities. It controls the actions between individuals and the government. 1. Constitutional law: Law that comes from the constitution of the country. 2. Administrative law: Law that governs the powers of the administrative agencies of the government. It controls the administrative operations of the government. For example, laws related to trade, economy, public service regulation of courts, environmental issues. 3. Criminal law: Concerns with maintaining justice, public order, safety, and individual's protection. It uses punishment against individuals that violate the law by limitation on their freedom (e.g. community services). It also rehabilitates the criminal for return to society. A crime is an offense and illegal act against the country committed in violation of general law. It is the behavior that causes harm to individuals. The police bring the criminal cases to court. The court considers a crime is committed if two elements are present: 1. The action is considered an offense 2. There was an intention to carry out the act. Criminal law may be categorized into a: 1. Felony: A crime punishable by death or imprisonment for more than one year. Examples: Abuse, illegal drug dealing, murder or attempted murder, practicing medicine without license, fraud, mayhem, and rape. 2. Misdemeanor: Less serious crime than felony. It is punishable by fines or imprisonment in a facility rather than a prison for one year or less. Examples: Traffic violations, thefts under certain amounts of money, and disturbing the peace. Civil law: A person can sue another person, business, or government. Examples: Contract violation, slander, trespassing, product liability, or automobile accident. Civil suits involve family matters such as divorce, child support, and child custody. - Court judgement in civil cases often require the payment of a sum of money to the injured party. - The person who brings the case to court Is known as the plaintiff. - The other party is called respondent. In civil law, 1. Tort: (it is accidental) A wrongful civil conduct that causes one party to suffer loss or harm resulting in the other person to compensate for the injured person. 2. Contract: (intentional) A legally binding agreement which governs the rights of the parties to the agreement. Main sources of law **in UAE:** - Sharia - Laws of the constitution - Civil laws Civil law system is the legal system adopted by the UAE. Legal system: Process of interpreting, enforcing, and applying the law. The purpose of a legal system: To provide a systematic mechanism for resolving disagreements. Two main types of legal system: 1. Common law system 2. Civil law system Common law system: Principles that evolved from judicial decisions of courts. It looks at the case from court previously and looks at the new facts. Examples of countries that apply common law system: United States and England. - It is not recognized or adopted in the UAE **Chapter 1.2** There are two types of government that run the UAE: - Federal and local governments. Both governments are supported by: - The federal entities and ministries at the federal level - The ruler's courts, the executive councils, the municipalities (بلديه), and the consultative councils at the local level. Traditional governance still exists in the UAE like, Majlis. The constitution was permanently adopted in July 1996. It has 152 articles establishing the rights of citizens in ten areas. It clarifies the mains rules of the political and constitutional organization in the UAE. The UAE is governed by five federal government authorities: 1. The federal supreme court 2. The UAE president and vice president 3. The federal council of ministries 4. The federal national council 5. The federal judiciary - **The federal supreme court** is the highest authority in the UAE. It consists of the rulers or all members of the UAE. They plan federal laws and approve the president's nominated prime minister and accept his resignation if required. - **The president and vice president:** Sheikh Mohammed Bin Zayed Al Nahyan is the president of UAE. Sheikh Mohammed Bin Rashed Al Maktoum is the vice president and prime minister of UAE. The president and vice president's term of office should be 5 years. - **Federal council of ministries:** consists of the prime minister, his deputies, and number of ministries. [They conduct all internal and external affairs.] - **Federal national council:** Consists of 40 members, it represents the entire people of the UAE. [Federal bills are presented to federal national council first], they discuss the bills and approve or reject them, then send them to president of the UAE who forwards them for approval of the Federal Supreme Council. - **Federal judiciary:** The basis of the government. Supports the country's stability and wellbeing. It is completely independent. Cases are handled by UAE courts [fairly] and without interference from any power. The legal structure in the UAE runs in two systems: 1. The federal judiciary: By the federal supreme court as the highest judicial authority in the UAE. 2. The local judicial departments: at the local government level. [The emirates of Sharjah, Ajman, Fujairah, and Umm Al Quwain follow the federal judicial system.] At the local level, 1. Abu Dhabi Judicial Department in Abu Dhabi 2. Dubai Courts in Dubai 3. Ras Al Khaimah Courts in Ras Al Khaimah The UAE adopts 3 levels of courts for litigation purposes. 1. Court of First Instance is the first degree of litigation and hears all civil, criminal, commercial, administrative, labor, and personal status lawsuits. 2. Court of Appeal is the second degree of litigation tries cases contested by the Court of First Instance. 3. Court of Cassation is the higher judiciary body with power to try cases contested by the Court of Appeals. It supervises the interpretation of laws and its proper enforcement. Judicial circuits are branches of court according to specialty. Each level of court has a circuit to look into cases such as: Personal status cases, criminal cases, and civil cases. 1. Labor court: handles cases filed by employees or employers against each other. 2. Personal status court: handles all family cases such as marriage, divorce, custody and visitation. 3. Civil courts: handle cases related to the financial rights of individuals and legal entities. Cases are related to validity, cancellation or termination of contracts, lands and mortgages. 4. Commercial courts: handle commercial contracts, banking processes, and commercial papers. 5. Criminal courts: handle criminal cases initiated by the federal or local actions in each emirate. **Chapter 1.3** A tort is a civil wrong committed against a person or property where a court provides a remedy in the form of an action for damages. There are 2 types of torts. - Intentional misconduct (willful) - Unintentional (accidental) **Intentional tort** is acts that describe an **intent to cause harm** to someone. It may also be crimes and can be prosecuted as criminal acts in separate court actions. Examples: Assault, battery, false imprisonment, defamation of character, invasion of privacy, infliction of mental distress, and fraud. [The most likely tort actions applied to prehospital care include assault, battery, and false imprisonment.] - Assault: Occurs when a person implants fear of immediate bodily harm or breach of bodily security. - Battery: Intentional touching of another person, in a socially impermissible manner, without that person's consent. Both assault and battery are closely related and often happen together. The difference between them is, Assault occurs [mentally.] Battery occurs [physically.] - Defamation of character: Communication of a false statement about another that harms their reputation. If the information is spoken orally, it is called slander. If it is in written form, it is called libel. To be a criminal, defamation must be communicated to a third person. Example: Reporting falsely that a patient has infectious disease, accusing him or her of a crime or sexual misconduct, or using words that harm person's profession or business. - False imprisonment: illegal restraint of person's personal liberty by another person or unlawful confining of an individual. To constitute false imprisonment, physical force is not mandatory. What is necessary is [implying fear by using words, threats, and gesture]. - Invasion of privacy: invading the privacy of a person to personal privacy. - Infliction of mental distress: causes painful emotions such as grief, public humiliation, despair, shame, and wounded pride. - Fraud: lying and deceiving to gain something unfairly or illegally. **Unintentional Torts** are the most common torts. They are acts that are not intended to cause harm but are committed unreasonably or without considering the consequences. They are also called "Tort of Negligence" which is the basis of malpractice claims and is the most common liability in medicine. - Negligence: Where one party owes a duty of care to another, breaches that duty, and harms the other patient. Negligence can be divided into: -Commission: Doing an act -Omission: Not doing an act, ignoring (Failure to act) - Malpractice: negligence of a professional person. It is considered a criminal conduct if it ignores the safety of another. 3 acts of negligence: 1. Malfeasance: Execution of an act that you are not authorized to do 2. Misfeasance: Improper performance of an act, resulting in injury to another 3. Nonfeasance: Failure to act There are 4 elements that must be present to prove guilty of negligence: 1. Duty of care 2. Breach of duty 3. Causation 4. Injury/Actual damages **[All four elements must be present in order to recover damages]** - Duty of care: The legal obligation of care, performance, or observance to safeguard the performance of others. - Breach of duty: The failure to conform to a required obligation owed by a person. This includes either performing the act or stop doing it. Remember, [Federal Decree Law No. 4 on Medical Liability (Article 3) ] Standards of care are legal guidelines that describe a minimal acceptable level of paramedic practice. Who determines standard of care in healthcare system in UAE? Governmental and administrative bodies. - Causation: The act is what caused harm or injuries. **The most challenging part of negligence lawsuit is proving that an act caused an injury.** The relationship between a breached duty and the injury is known as [proximate cause.] - Injury/damages: The damage can be: -Economic loss: Medical expenses, lost income, care services, and expected loss of future earnings. -Non-economic loss: Physical injury, emotional distress, pain and suffering. **Chapter 1.4** Liability is the state of being legally responsible for something. When the civil lawsuit is brought to the court, the first action is to decide if the plaintiff has a legal reason to sue or if the respondent is liable. The main objective of civil lawsuit is compensations for the damages or injury the plaintiff sustained. Common civil lawsuits against paramedics: - Emergency vehicle crashes - Dispatch and transport issues - The quality of medical care Criminal prosecution is an action taken by the government against a person who has violated criminal laws. Compare and contrast between civil lawsuit and criminal lawsuit: Civil lawsuit: -Private law, between individuals against each other and between individuals and organization. Criminal lawsuit: -General law, punishable by imprisonment or death, between government and individual. Medical error is error committed by a practitioner due to: - Ignorance - Non-compliance with medical and professional principles - Not exercising due diligence (Not practicing in the right way) - Negligence and not paying attention When medical errors occur, victims in the UAE can complain in 3 ways: 1. Filing a medical complaint 2. Filing a civil case 3. Filing a criminal complaint The complaint shall be submitted to a "Medical Liability Committee" before they are reviewed by the judicial bodies. - Grievances: Healthcare professionals have the right to challenge the report of the Medical Liability Committee within 30 days from the date they are notified of the committee's decision. - The Medical Liability Supreme Committee is responsible for examining grievances filed by patients and healthcare professionals against reports issued by the Medical Liability Committee. Paramedics can have two key defenses: 1. Contributory negligence: The injury may not be because of the paramedic 2. Voluntary assumption of risk: the patient agreed to take responsibility of the risk The paramedic receives orders from the medical director through: Radio, mobile phone, or protocols. **Chapter 2.1 & 2.2, 2.4&2.5** Patient's rights are the moral and legal entitlements of an eligible patient while being treated at any healthcare facility. **Why are patient's rights important?** - They include many important ethical issues like autonomy, informed consent, privacy, confidentiality, risk information, refusal of treatment, personal safety and protection. -Supporting patient's rights will improve healthcare systems and safety, also improve trust between the patient and the community.  **Chapter 2.3** Consent is a voluntary agreement by a person who has a mental capacity to make an intelligent choice to allow something to be performed on themselves. This right of choice is found in the ethical principle of autonomy, which is the individual's right to make their decisions. For valid and lawful consent, four elements should be available: 1. The patient gives the consent voluntarily. 2. The patient has been provided with sufficient information. 3. The consent includes the treatment to be provided. 4. The patient is of legal age and possesses decision-making capacity. Reasons for declaring incompetence (not being able to make their decisions by themselves): - Inadequate age (minor) - Mental disability - Impairment of judgement by drugs - Acute disturbances of consciousness - Impaired reasoning or memory loss caused by disease/injury If the patient cannot make their own decision, a legal authorized person should be selected to make decision on behalf of the patient. **FORMS OF CONSENT:** - Expressed consent: Can be in form of verbal or written document. - Implied consent: Determined by some act which raises resumption that consent is authorized. Informed consent is a legal concept that provides that the patient has to know the potential risks, benefits, and alternatives of a procedure. There are 4 steps that the paramedic must follow to obtain an informed consent: 1. Explain the suspected injury or illness to the patient 2. Describe the treatment to be administered, and the potential risks of that treatment 3. Discuss any other treatment options available 4. Advise the patient regarding possible consequences of refusing treatment. Circumstances where consent is not required: - Emergency situation - A non-emergency situation - A case where the law authorizes prescribed treatment in very specific circumstances Refusal of treatment will be considered valid **if:** - The patient has sufficient decision -making capacity - The decision is made voluntarily - The decision should be specific and relates to the situation - The patient has been provided with information that will assist them with their decision-making. If they refuse treatment, they must give a refusal statement that is clear and related to the current circumstances. **Chapter 3.1** **Administrative regulations** affect and define the specific rules under which paramedics practice. Educations include all of the cognitive, psychomotor, and affective learning that individuals undergo throughout their lives. Education can be through: **Formal** or **informal** learning processes. Levels of education EMS career may vary: 1. Technical / career schools or college 2. University or 4-year college 3. Continuing education: continuous professional development **Accreditation:** A process education programs may complete that ensures certain standards have met. **Certification:** A person has fulfilled requirements of education and performance and meets the standards and qualifications. **Licensure:** Grants the right to practice certain skills within the scope of practice. **Registration:** An entry in record, listing the names of persons in a certain occupation who have satisfied specific requirements within a profession. **Scope of practice:** A legal description of the distinction between licensed healthcare professionals and the public as well as among the different levels of licensed healthcare professionals. It defines what is legally permitted to be done. There are 4 levels of EMS: - Emergency medical responder - Emergency medical technician - Advanced EMT - Paramedic Roles of the dispatcher in the EMS system: - Receives and enters all information on the call - Interprets the information - May also give directions and tasks pre-arrival such as CPR or hemorrhage control. - Emergency medical responder: Out of hospital practitioner that initiates immediate lifesaving care to patient. - Emergency medical technician: (Historically called EMT-Basic) They assess urgent and non-urgent requests for medical care, apply basic knowledge and skills necessary to provide patient care and medical transportation. - Advanced EMT: (historically called EMT-Intermediate) Respond to, assess non-urgent and urgent requests for medical care, apply basic and focus advanced knowledge and skill necessary to provide patient care and medical transportation and facilitate access to higher level of lifesaving care. - Paramedic: Respond to, assess non-urgent, urgent requests for medical care. They apply basic and advanced knowledge and skills necessary to determine patient physiologic, psychological, and psychosocial needs. They administer medications, interpret and use diagnostic findings to implement treatment. And they provide complex patient care. **Chapter 3.2** The UAE vision 2021 national Agenda wants to achieve a world-class healthcare system. Local Health Authority: -Department of Health Abu Dhabi -- Department of Health Dubai Federal Health Authority: -Ministry of Health and Prevention National Ambulance provides EMS services for **[all]** UAE population. **Chapter 3.3** General requirements of paramedics' licensure in UAE: - Educational qualifications - Professional experiences - Professional licenses - Primary source verification - Assessment - Discontinuity of practice Assessment: - Emirati students are exempted from the authority examinations (not required to do the exam). - The applicant is required to pass the assessment to obtain the professional license in the UAE. - English language will be used to conduct the assessment with no translation. It will be oral, written, objective, and OSCE. - The applicant has only 3 attempts to pass the assessment. - The applicant must declare the number of attempts they have undertaken across the authorities. **Chapter 3.4** An ambulance is a vehicle that is equipped with mobile hospital medical care for transportation of patients in severe emergency condition. The medical conditions that are required to call the ambulance: - Signs and symptoms of acute cardiac distress (chest pain), heart attack, shortness of breath, stroke. - Severe bleeding/hemorrhage, risk of blood loss from internal bleedings (intracranial hemorrhage). - Life-threatening trauma loss of consciousness, extensive burns, severe fractures and injuries. - Immediate oxygen requirement. - The patient is unable to move not even in a wheelchair. **Good Samaritan Law** offers legal protection to public and citizens who give reasonable assistance, advice or care to those who are at risk of death or injury. **Chapter 4.1** **Ethics** is a branch of philosophy that pursues to understand the nature, justification, purposes and founding the principles of moral rules. **Microethics:** the individual's views on what is right and wrong **Macroethics:** the global view of what is right and wrong **Morality** is a class of rules that are held by society to govern the conducts of the individual members. **Moral values** are formed from your family, culture, and society influences. **Code of conduct** can be defined as a formal statement explaining the ethical standards of an organization or profession. **Standards:** Used to guide human conduct by stating desirable traits to be made. **Principles:** Used to describe responsibilities that do not specify what should be the required conduct. **Rules:** Do not allow for individual professional judgment. **Moral judgement:** Judgements that are concerned with the beliefs of an individual to be the right in a given situation. **Chapter 4.2** The study of the origin and meanings of ethical concepts is known as **meta-ethics.** **Normative ethics** is a perspective that attempts to determine the moral standards that should be followed. **Descriptive ethics:** The study of what people believe to be right or wrong and why they believe it. **Applied ethics:** Philosophical search for right and wrong within controversial scenarios. Main approaches of normative ethics: - Consequentialist ethics (Utilitarianism= greatest good for the greatest number, and Hedonism= the best outcome is the outcome that produces the most happiness) - Deontological ethics - Virtue ethics **Chapter 4.3** The four principles of bioethics: - **Autonomy (Patient's right to make decisions)** - **Non-maleficence (Avoid causing harm to the patient)** - **Beneficence (Doing good, showing compassion, balancing benefits against risks)** - **Justice (Being fair in distribution of benefits and risks)** **Chapter 5.1** ***PRECARE*** Decision-making model: helps the paramedics to meet their challenges of decision-making. **P:** Problem -- Identify the problem **R:** Reconnaissance -- Get the facts **E:** Ethics -- Consider the 4 bioethics **C:** Code -- Consider the code of conduct (Law takes more importance than code of conduct) **A:** Alternative -- Consider an alternative approach **R:** Regulations - Consider the relevant legal regulations **E:** Evaluate -- Evaluate the decision and make your final decision **Chapter 5.2** *History of codes and their Basis* - Code of Hammurabi (in the Babylonian empire) - Roman Law's Code of Justinian (The Byzantine) Governance means to govern. The area of control or governance can be divided into three main domains: 1. Self-governance 2. Group-governance 3. Legal regime **Chapter 5.3** *Ethical Challenges and Issues:* - Ethical health issues before medical intervention: - Justice and autonomy. - Finding an address associated problem - **Stigmatization:** Occurs in relation to individual's diseases, locations, social, and cultural criticism. Examples: Care administrating to drug addicts, alcoholics, and terminal cancer patients. - Refusal of transport to hospital - Dangerous situations interventions - Safe driving B. Ethical issues related to the treatment process - Beneficence and non-maleficence - Triage (Means to sort) -- prioritize the patient -Get the right patient -To the right place -To the right time - Disagreement between patients, families and healthcare providers over treatment decisions and dealing with difficult patients Difficult patients can mean either: - Patients who are intoxicated (by alcohol or drugs) - Patients who are terrified or agitated. - Dealing with the public, patient relatives, and bystanders - Achieving informed consent - Decision-making capacity - Truth telling - Patient privacy and confidentiality - Relationships within the crew and between other healthcare professionals - Waiting lists - Ethical issues related to participation in research and clinical traits - Surgical innovation ethics - Issues related to the access for needed health resources for the aged, chronic and mentally ill people - The issue of medical error - The shortage of family physicians, emergency medicine and primary care teams in rural and urban settings C. Ethical issue related to some perceptions of using the ambulance D. Other basic ethical considerations (Respect for human life, taking account of human's life quality, respecting the integrity of human body) **Chapter 5.4** **Euthanasia** -- Mercy killing (Good death or easy death) It has moral, ethical, and legal conflict. There are many risks ***[KNOW FEDERAL DECREE LAW N0. 4 ON MEDICAL LIABILITY, ARTICLE 10,]*** "Patient's life may not be terminated for any reason whatsoever, even at his request or that of his guardian or custodian. Resuscitation equipment may not be removed unless the heart and respiration completely stop, or all brain functions stop." **Abandonment:** termination of care without consent or without ensuring transfer of care to appropriate level of care provider. **Advance directives:** Living will Documentation should include: - Location of the advance directive - Name of the patient - The telephone number - Any info that might be helpful in the patient's immediate care situation The patient must be competent, make the directive freely and voluntarily **The living will:** - Provides guidance about patient wishes for treatments - Provides legally valid instructions related to treatment - Protects the patient's rights It may indicate: 1. Preference regarding organ donation 2. Autopsy 3. Alternative treatment **[In UAE, it is not permitted to use a living will.]** Power of Attorney: Permits an individual "principal" to give another patient "attorney-in-fact" the authority to act on their behalf. Types: 1. General 2. Special It must indicate the identity of the principal's attorney and that the principal has communicated clearly about his wishes to the attorney. The general power of attorney may continue *forever.* **Healthcare proxy:** Allows the person to appoint healthcare agent to make a decision on their behalf. **Organ donor directive:** A document that indicates client's wishes to donate organs for transplantation when patient dies. *[UAE allows transplantation of human organs and tissues from both living and deceased donors.]* **Surrogate decision-making**: An agent who acts on behalf of the patient who lacks capacity and unable to make their own decisions. **Futile CPR treatment:** A failure to save a life by CPR. **Do not resuscitate orders:** are specific written directions that a person does **[NOT]** wish to be resuscitated if they suffer a catastrophic event such as cardiac arrest. They are advance directives. **[In UAE, healthcare facilities do not permit DNR orders to be written in the patient's chart.]** **Withhold treatment:** A decision not to initiate or medical intervention for the patient, made when there is no hope for recovery and death is eminent. **Withdraw treatment:** A decision to discontinue treatment or medical intervention when death is eminent and cannot be prevented by medical treatment. Common reasons for withdrawing or withholding treatment: - Patient choice - Burden outweigh benefits - Undesirable quality of life - Prolonging the dying process **MOLST** -- Medical Orders for Life-Sustaining Treatment *MOLST - For all types of treatment* *DNR -- CPR only* **[In UAE, this is not applicable by law.]** [Qualified paramedic or EMT can diagnose death] [A medical practitioner can provide certification of death] Diagnosis of death: - Fixed and dilated pupils, no palpable pulse, no CPR 20 minutes, injuries, Asystole on ECG - Await police special ambulance for removal of body - Diagnosis of death form should include all findings along with the full name of person, location of death, estimated date and time of death, name of the paramedic conducting the assessment and other staff in attendance - Attending crew remain on scene until black ambulance arrives or Crime Scene Investigator (CSI) if suspicious / unexpected death. **Chapter 6.1** PCR: **Patient Care Record** PCR can be categorized into: - Objective information: measurable signs such as blood pressure and temperature - Subjective information: information that is told to the paramedic like symptoms The standards of PCR include: - Accurate and factual - Complete - Legibility - Objectivity - Timeless - Validity **Chapter 6.2** Disadvantages of paper PCR and the reasons that led to electronic documentation: - Paper PCR must be entered I nan electronic system - They require space to store the records - Spelling mistakes and medical errors Clinical assessment: - Run data: incident times, locations, responding units, crew members names who are working at the incident - Patient's data: chief complaint, vital signs, assessment, level of consciousness, and patient's demographics (age, sex, ethnic background) **Chapter 6.3** **Mass casualty incidents:** Cases of alleged abuse or negligence. (PCR) Different methods of documentation: - Chronological order - SOAP -- Subjective information, Objective information, Assessment, and Plan for the treatment - CHARTE method -- Chief complaint, History, Assessment, Treatment and Transport, Expectations - Body systems approach - Source -- Oriented medical Reports (SOMR) - Problem -- Oriented Medical Report (POMR) - PIE charting method -- P: Patient reports pain as 8/10, I: Given Morphine, E: Patient reports pain 2/10 - Focus charting method -- column format and consists of 1. Data 2: Action 3: Response The six C's of proper documentation: - Client's words - Conciseness - Clarity - Chronological - Confidentiality - Completeness **Chapter 6.4** Successful Healthcare Innovation in UAE: 1. Dubai Health Authority established unified electronic medical record system "**Salama"**. It aims to centralize access to records for patients and doctors through the new portal across DHA. 2. **Smart ambulance:** Have access to patient's records through the EMR system to update patients' information, as well as internet access to contact the medical team. 3. **Big data analysis** 4. SKMC -- has incorporated **"iCare"** which is an Electronic Medical Records (EMR) system. 5. "eclaim" -- cutting down time-consuming paperwork Federal Decree Law No. 4 on Medical Liability, Article 5: A physician shall not: Disclose patients' secrets.. Storing of health records: - Should be both in English and Arabic - Each health facility should provide temperature-controlled health record room - Health records should be stored securely to be protected from loss, damage, unauthorized use or theft An authorized healthcare provider should retain records for a period of **at least 2 years** from the date of the last health insurance treatment and may only be disposed of **permanently 5 years** after the last treatment. Paper based health records of **UAE national patients** should be retained for up to **10 years** Paper based **dental records** should be stored for **10 years** for both UAE nationals and expatriate patients Paper based health records of **medico-legal cases** should be retained up to **20 years.** Files of **deceased patients** should be retained by the health facility up to **5 years.** **Digital health information** should be retained for a minimum period of **25 years** from the date of the last health procedure. **No disposal or destruction** for birth and death medical records and for cases of ongoing investigation. [Methods of destruction: Shredding, trammeling, pulping.] **Chapter 7** **Profession** is a declaration of belief in a religion, occupation **Vocation** is a calling from God about the occupation and profession that the person pursues for a living. Is paramedicine a profession? A paramedic is a healthcare professional who is specialized in responding to emergency calls for medical help out of the hospital setting. It is a profession because paramedics are required to practice with honesty and knowledge. What are the three most professional responsibilities most relevant to social media are of professionalism? 1. Commitment to patient confidentiality 2. Commitment to maintaining appropriate relations with patients 3. Commitment to professional responsibilities Examples of social media content that you encountered that had violated electronic communication professionalism guidelines: - Breaching of patient privacy - Damage to professional image - Use of discriminatory language Describe what steps should be taken after viewing or receiving inappropriate content: - Keep personal and professional profiles separate - Use the most secure privacy settings available Examples of healthcare professional generated social media content that is professional and allows for individual expression: - Professional education, online communication - Patient care - Patient education Techniques that healthcare providers can use social media in a professional way to help meet their responsibilities towards patients: - Avoid writing about specific patients - Make sure you are in compliance with state and federal privacy laws - Obtain patient consent when required - Aims to get the right response, to the right patient, in the right time In what ways are new technologies relevant to CBEH? - Increasing health literacy skills - Building social support networks Some strategies to reduce unnecessary emergency visits can be by: - Calling your doctor before heading to the emergency department - Promoting the use of personal health triage applications - Offering telehealth as a possible alternative to the ER