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Chapter 3- Medical, Legal, & Ethical Issues (From a legal standpoint…
Chapter 3- Medical, Legal, & Ethical Issues
From a legal standpoint you must understand the various legal aspects that go along with working in the emergency medical field.
Often times than not EMT's are faced with making the right decisions. Some situations can become difficult to where they challenge you to make a quick, decisive, professional decision.
To medically treat patients there must be some form of consent. Either it being Implied, Informed, Expressed, or Involuntary.
To be ethical in the workplace you are to represent the ethics of honesty, equality, fairness, integrity, and lead by example.
Much like our every day lives, we make right decisions and we make wrong decisions. Knowing when to make those choices is being ethical. In the work environment as a EMT you are going to have to make some difficult decisions for the patient, but we have their best interest in their well being at heart.
Medical treatment for a patient needed with written documentation shown is called a Advance directive. It helps when the patient is not able to make their own decisions medically.
A patient who is capable to make their own medical decisions is considered competent to do so. Meaning they are in the right frame of mind to do so.
Decision making requires a clear and knowledgeable mindset to make well though out decisions that have the best outcome possible for the patient. This being a decision-making capacity.
Those in the medical field hold a title of responsibility to always help those who are in need of help. To provide the up most care, to act on the duty of the job in which serves the community.
There is a Act with its purpose is to protect patient privacy. This Act was known as HIPAA which stands for Health Insurance Portability and Accountability. It was first produced and came to be in 1996. It requires all medical patient information to remain safe in conidfentiality always.
When that patient information is leaked without patient permission it results in what is known as a breach of confidentiality. Such information being shared unknown to the patient is a liability and a lawsuit to take place possibly.
As an EMT there will come times where you are not to revive a patient if they go into full arrest. There is a document known as a DNR which stand for Do Not Resuscitate. This order is is given by a Physician. This order usually states what the patients medical problems are, and what the acceptable interventions are for this patient, if any.
DNR's all have expiration dates. Usually for every 12 months. Once it expires you are to get another through your physician.
On a DNR it must have your physicians signature, as well as your signature(the patient). A statement of current medical issues taking place with the patient. In some DNR's patients have chosen what is known as a surrogate to make all decisions for them.
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The tricky thing about a DNR is as a EMT we are to still try to provide supportive life saving measeurments for that patient. If what they are experiencing is not due to what illness is stated in the DNR.
When giving false information about a patient, or even slandering their character as a person is considered defamation.
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The patients that can't verbally express consent are considered Implied Consent. This gives the legal statement that they would like treatment.
When a EMT tells a patient what is wrong with them, and what they are able to do as a medical provider to treat them they are giving Informed Consent.
A legal doctrine that states consent for treatment is undertaked by schools who are responsible for their students.
Not all minors require consent from their parents and guardians. Those being minors who are emancipated from their parents. Which allows them legally to make their own decisions both medically and however else they please. In some cases their under 18 years old even.
Scope of Practice is what is within your legal authorization as a medical provider to be able to do.If ever as a EMT you were to insert a IV into a patient for example. That would be considered out of your scope of practice because that is within a paramedics scope of practice not a EMT's.
As an EMT you will come across patients who do not want to be treated. This is known as refusal of care. As long as you document it all, as well as explain the risks to the patient then they are okay to be left alone. It helps to get a signature by them as well documenting refusement of transport and treatment taking place.
Assault, Battery, Kidnapping, and false imprisonment are all situations that may arise in the field with a patient. Good to always be observant of your surroundings and scene.
Elements of patient negligence include Duty to Act, Breach of that Duty, Damages, and proximate cause.
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To verbally express that you give permission to be treated is known as expressed consent. Not every patient though is able to verbally make it know that they do consent.
Involuntary Consent apples when a patient who is mentally unstable and unable to make the appropriate decisions medically for themselves. These patients also could be physically and developmentally delayed. Usually these patients have a provider with them to make and decide decisions for that individual.
Signs of death usually are seen through pulselessness, no systolic blood pressure being found, a cold skin temperature on the body. A lack in response to pain stimulil, no heartbeat being detected. Blue cyanoises around the lips and mouth area. Stiffness which is onset of rigor mortis settling in.
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When an EMT acts out of code or conduct, or violates standard of care that is a breach of duty.
Damages refer to any financial, Physical, or compensable physical harm.
Termination of care of a patient without assuring continuation of care at the same level or higher is known as abandonment.
Your role as an EMT when coming across a patient who is a organ donor is to to treat how you would treat every other patient of course. You would then notify medical direction, and lastly provide care to keep those organs that are for donation, vital.
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