Unit 3

Unit 3 Legal Responsibilities of the EMT

Overview • • • • •

Knowledge of standard care Patient’s rights Collaborating with law enforcement Common allegations against an EMS Protection against lawsuits

Introduction • EMT has many legal responsibilities • Legal duty to provide care in same manner as other EMTs • EMT must be familiar with pertinent laws

The Legal Responsibilities of an EMT • Medical protocols – Set of written regulations detailing proper procedure for caring for patient

• Knowledge of standard of care – EMTs must act within specific guidelines

• Legal duty to act – Failure to treat patient within standard of care may constitute patient abandonment

The Legal Responsibilities of an EMT (cont’d.) • Patient’s bill of rights • Respect for patient’s rights – Patient information must not be disclosed without patient’s permission – Failure to maintain confidential patient information is breach of confidentiality

The Legal Responsibilities of an EMT (cont’d.) • Health insurance portability and accountability act (HIPAA) – Allows insurance portability and continuity – Standardization of administrative and financial data exchange – Protection of privacy, confidentiality, and security of health care information

The Legal Responsibilities of an EMT (cont’d.) • Obtaining patient consent – Types of consent • Informed consent • Express consent • Implied consent

– Children and adolescents • In loco parentis: allows adult sibling or close relative to give consent

The Legal Responsibilities of an EMT (cont’d.) • Obtaining patient consent (cont’d.) – Prisoners, mentally disturbed persons, and consent • Emergency doctrine • Courts may authorize specific treatments • Preplanning can prevent legal problems later

The Legal Responsibilities of an EMT (cont’d.) • Right to refuse care – AMA vs. RMA • A refusal of medical assistance (AMA) – Low priority or nonemergency situation

• Refusal against medical advice (RMA) – Life threatening situation

– Advance directives • Living will or do not resuscitate order (DNR) • Health care proxy

The Legal Responsibilities of an EMT (cont’d.)

The Legal Responsibilities of an EMT (cont’d.) • Documentation – EMT’s report will become part of patient’s medical record – Accuracy and completeness are essential

• Initiating resuscitation – Absence of pulse and breathing requires start of CPR unless DNR order or unambiguous signs of death are present

The Legal Responsibilities of an EMT (cont’d.)

Collaborating with Law Enforcement • Challenges – Treating patient who may be participant in crime – Trying not to disturb evidence – Knowing when a scene is a crime scene – Patient care takes priority over evidence collection

Collaborating with Law Enforcement (cont’d.) • Motor vehicle collisions –EMT should be evidence conscious • May be asked to testify • Consider as potential crime scene • Carefully document observations

Collaborating with Law Enforcement (cont’d.) • Threat of violence on the scene – Personal safety is first priority – Never enter unsafe scene without police

• Physical restraint of combative patients – EMT may use physical restraint to prevent harm to patient or others

Reporting of Abuse • Child abuse – Special role in detecting and reporting child abuse • Mandated reporter

• Domestic violence – Must be nonjudgmental and empathetic

• Elder abuse and neglect – Social services referral system

Common Allegations Against EMS • Ambulance collisions and liability – Operator responsible for damages or injuries incurred due to lack of due regard

• Negligence – Malpractice is damage to patient – Tort law involves civil wrongs against another – Negligence is care given below standard

Common Allegations Against EMS (cont’d.) • Four elements of negligence – Duty to act – Breach of duty to act – Causation of Injury – Damages

Common Allegations Against EMS (cont’d.) • Patient abandonment – Duty to continue care until relieved – EMT can be held responsible for injuries resulting from abandonment

• Assault and battery – Transport of patient without consent may result in charges of assault, battery, and false imprisonment

Common Allegations Against EMS (cont’d.) • Breach of confidentiality – The emergency medical treatment and active labor act (EMTALA) • Part of Consolidated Omnibus Budget Reconciliation Act (COBRA) • Known as “antidumping” law • Protects patients whom hospitals might refuse to care for

Protection Against Lawsuits • Good Samaritan laws – Encourages health care professionals to help others in public situations

• Immunity statutes – Protects health care providers from paying damages for acts performed at work

• Best practices – Follows protocols and use compassion

Conclusion • Specific legal responsibilities vary from state to state • Advice of an attorney can be invaluable • EMTs must protect themselves from threat of legal action • Best protection is good patient care and conscientiousness