Chapter 3 Medical, Legal, and Ethical Issues

You are treating a patient with an apparent emotional crisis. After the patient refuses treatment, you tell him that you will call the police and have him restrained if he does not give you consent. Your actions in this case are an example of: A. assault. B. battery. C. negligence. D. abandonment.

A. assault. Rationale: Unlawfully placing a person in fear of immediate bodily harm (ie, having him restrained) without his consent constitutes assault.

An 8-year-old boy was struck by a car, is unconscious, and is bleeding from the mouth. A police officer tells you that he is unable to contact the child's parents. You should: A. continue to treat the child and transport as soon as possible. B. cease all treatment until the child's parents can be contacted. C. continue with treatment only if authorized by medical control. D. provide airway management only until the parents are contacted.

A. continue to treat the child and transport as soon as possible. Rationale: The child in this scenario is critically injured and requires immediate treatment and transport; waiting until his parents are contacted wastes time and increases his chance of a negative outcome. If you are unable to contact a minor's parents or legal guardian, you should proceed with care based on the law of implied consent.

The EMT has a legal duty to act if he or she is: A. off duty and witnesses a major car accident. B. a volunteer, is on duty, and is dispatched on a call. C. paid for his or her services, but is not on duty. D. out of his or her jurisdiction and sees a man choking.

B. a volunteer, is on duty, and is dispatched on a call. Rationale: The EMT—paid or volunteer—has a legal duty to act if he or she is on duty and is dispatched on a call, regardless of the nature of the call. If the EMT is off duty and/or out of his or her jurisdiction, he or she has a moral obligation to act, but not necessarily a legal one.

Which of the following patients is competent and can legally refuse EMS care? A. A confused young female who states that she is the president B. A man who is staggering and states that he drank only three beers C. A conscious and alert woman who is in severe pain from a broken leg D. A diabetic patient who has slurred speech and is not aware of the date

C. A conscious and alert woman who is in severe pain from a broken leg Rationale: A patient who is of legal age (18 in most states), is conscious, and is alert to person, place, time, and event, likely has decision-making capacity and can legally refuse EMS care. However, patients who are confused, possibly intoxicated, or delusional are not capable of making rational decisions; therefore, you should provide care based on the law of implied consent.

An advance directive is: A. a set of specific guidelines that clearly defines the different types of consent. B. a formal list that defines by state law whether a patient has decision-making capacity. C. a written document that specifies the care you should provide if the patient is unable to make decisions. D.a verbal order given to you by a dying patient's family regarding whether treatment should be provided.

C. a written document that specifies the care you should provide if the patient is unable to make decisions. Rationale: An advance directive is a written document signed by the patient and a witness that specifies the medical care that should be provided if the patient loses decision-making capacity (ie, he or she is no longer deemed competent).

You arrive at the scene of an older woman complaining of chest pain. In assessing her, she holds her arm out for you to take her blood pressure. This is an example of: A. implied consent. B. informed consent. C. expressed consent. D. emergency consent.

C. expressed consent. Rationale: Expressed consent (also called actual consent) is when the patient authorizes you to provide treatment and transport, either verbally or nonverbally. For example, a patient who holds out his or her arm to allow you take a blood pressure is nonverbally giving you expressed consent.

The unauthorized confinement of a person is called: A. assault. B. battery. C. false imprisonment. D. slander.

C. false imprisonment. Rationale: False imprisonment is defined as the confinement of a person without legal authority or the person's consent.

Failure of the EMT to provide the same care as another EMT with the same training is called: A. libel. B. slander. C. negligence. D.abandonment.

C. negligence. Rationale: An EMT could be held liable for negligence if he or she fails to provide the same care as another EMT with the same training would provide in the same situation. For example, if an EMT fails to give oxygen to a patient with shortness of breath (an intervention that is clearly indicated), he or she may be held liable for negligence.

Which of the following is an example of abandonment? A. An EMT leaves the scene after a competent adult has refused care. B. An EMT transfers care of a patient to an emergency department nurse. C. An AEMT transfers care of a patient to a paramedic. D. An AEMT transfers care of a patient to an EMR.

D. An AEMT transfers care of a patient to an EMR. Rationale: Abandonment occurs when patient care is terminated without the patient's consent or when care is transferred to a provider of lesser training and level of certification.

Which of the following statements about records and reports is FALSE? A. Legally, if it was not documented, it was not performed. B. A complete, accurate report is an important safeguard against legal problems. C. An incomplete or untidy patient care report is evidence of incomplete or inexpert emergency medical care. D. Your patient care report does not become a part of the patient's hospital record because your treatment was provided outside the hospital.

D. Your patient care report does not become a part of the patient's hospital record because your treatment was provided outside the hospital. Rationale: The statement "Your patient care report does not become a part of the patient's hospital record because your treatment was provided outside the hospital" is incorrect. Your patient care report does, in fact, become a permanent part of the patient's hospital record.

Where would you most likely find information regarding a patient's wishes to be an organ donor? a. Driver's license b. Insurance card c. Voter registration card d. Social Security card

a. Driver's license

Which type of consent is involved when a 39-year-old, mentally competent female with a severe headache asks you to take her to the hospital? a. Expressed. b. Formal c. Informed d. Implied

a. Expressed.

While transporting a woman with diabetes, you inadvertently give her oral glucose even though her blood glucose level was high. You reassess the patient and note that her condition did not change; she remained stable. You should: a. contact medical control and notify them of the error. b. notify law enforcement so they can file an incident report. c. document the error and report it to your supervisor. d. exclude this intervention from the PCR because it did not harm the patient.

a. contact medical control and notify them of the error.

You suspect that a pregnant 16-year-old girl has a broken leg after she was hit by a car. You explain that you plan to splint her leg, and she agrees to treatment. Which of the following types of consent describes her agreement? a. Informed b. Minor's c. Implied d. Expressed

b. Minor's

When is forcible restraint permitted? a. Anytime that the EMT feels threatened b. When the patient poses a significant threat to self or others c. Only if consent to restrain is given by a family member d. Only if law enforcement personnel have witnessed threatening behavior

b. When the patient poses a significant threat to self or others

While transporting a stable patient with chest pain to the hospital, you come across a major motor vehicle crash involving several critically injured patients. You should: a. stop and triage the patients while your partner remains in the ambulance. b. continue transporting your patient and notify the dispatcher of the crash. c. remain at the scene until law enforcement and another ambulance arrive. d. ask a bystander to remain with your patient as you treat the crash victims.

b. continue transporting your patient and notify the dispatcher of the crash.

You are dispatched to an office building for a 49-year-old male with chest pain. When you arrive at the scene, you find the patient to be conscious and alert but in obvious pain. He tells you that he did not call 911; a coworker did. He further states that he does not want to be treated or transported to the hospital. You should: a. have him sign a refusal of care form and then return to service. b. ensure that he is aware of the risks of refusing medical care. c. tell him that he is having a heart attack and needs medical care. d. err in the best interest of the patient and transport him at once.

b. ensure that he is aware of the risks of refusing medical care.

In the eyes of the courts, an incomplete or untidy patient care form indicates: a. potential falsification of the patient care form. b. inadequate patient care was administered. c. the EMT was too busy providing patient care to fill out the form. d. thorough documentation was not required.

b. inadequate patient care was administered.

In many states, a minor may be treated as an adult for the purpose of consenting to or refusing medical treatment if the minor: a. is mentally competent and able to refuse. b. is self-supporting and lives by him- or herself. c. possesses a valid driver's license. d. has a poor relationship with his or her parents.

b. is self-supporting and lives by him- or herself.

To minimize the risk of litigation, the EMT should: a. always transport patients to the hospital of their choice. b. provide competent care that meets current standards. c. use universal precautions with every patient encounter. d. utilize at least four personnel when moving a patient.

b. provide competent care that meets current standards.

You and your partner are the first to arrive at a potential crime scene with a critically injured patient involved. The scene is safe. Your first priority is to: a. wait for law enforcement to arrive. b. provide immediate patient care. c. notify medical control for advice. d. determine why the patient was injured.

b. provide immediate patient care.

The manner in which the EMT must act or behave when caring for a patient is called the: a. scope of practice. b. standard of care. c. EMT oath. d. code of ethics.

b. standard of care.

Your best protection against legal liability when a patient with decision-making capacity refuses EMS care and transport is to: a. ensure that the family is aware of the risks. b. thoroughly document the entire event. c. err on the side of caution and transport. d. advise medical control of the situation.

b. thoroughly document the entire event.

Which of the following general statements regarding consent is correct? a. All patients older than 18 years can legally refuse treatment or transport.. b. Patients who are intoxicated are generally allowed to refuse treatment. c. A patient can consent to transport but can legally refuse treatment. d. Expressed consent is valid only if given in writing by a family member.

c. A patient can consent to transport but can legally refuse treatment.

Acting in such a way as to make another person fear immediate bodily harm is called: a. negligence. b. battery. c. assault. d. libel.

c. assault.

You receive a subpoena to testify in court regarding a case that occurred two years ago in which you and your partner did not attempt resuscitation of a cardiac arrest patient. Upon receiving the subpoena, you should: a. attach an official addendum to the original patient care report. b. call the district attorney's office and explain the details of the case. c. notify the director of your EMS system and obtain legal counsel. d. contact the patient's family in an attempt to resolve the matter with them.

c. notify the director of your EMS system and obtain legal counsel.

You are treating a man who was assaulted and has a closed-head injury. The patient, who has slurred speech, becomes verbally abusive and tells you to leave him alone. You should: a. allow the patient to refuse treatment because the injury was not his fault. b. have the police arrest the patient so that you can legally begin treatment. c. proceed with treatment and utilize law enforcement for assistance if necessary. d. ask a police officer to transport the patient to the hospital.

c. proceed with treatment and utilize law enforcement for assistance if necessary.

You are dispatched to an apartment complex to respond to a shooting. Law enforcement personnel are present and have the suspect in custody. You find the patient lying in a narrow space between the couch and coffee table of his small apartment. He is semiconscious and has a large gunshot wound to his chest. You should: a. obtain permission from law enforcement before moving anything. b. drag the patient into a larger area so that you can begin treatment. c. quickly move the coffee table so you can access and treat the patient. d. treat the patient where he is so that you do not destroy any evidence.

c. quickly move the coffee table so you can access and treat the patient.

Which of the following patients has decision-making capacity and can legally refuse emergency medical treatment? a. A confused young male who says he is the president b. A man who is staggering and states that he had three beers c. A diabetic woman who has slurred speech and is not aware of the date d. A conscious and alert woman with severe abdominal pain

d. A conscious and alert woman with severe abdominal pain

When you and your partner arrive at the residence of a man in cardiac arrest, you immediately recognize the patient as the drunk driver who killed your brother several years earlier. A backup ambulance is en route to the scene. You should: a. wait for the backup ambulance while your partner performs CPR. b. advise your partner that you cannot provide care to this patient. c. obtain permission from medical control to not attempt resuscitation. d. begin two-rescuer CPR and apply the AED as soon as possible.

d. begin two-rescuer CPR and apply the AED as soon as possible.