• Like
3)Medico Legal And Ethical Issues
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

3)Medico Legal And Ethical Issues

  • 10,330 views
Published

 

Published in Technology , Business
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
No Downloads

Views

Total Views
10,330
On SlideShare
0
From Embeds
0
Number of Embeds
3

Actions

Shares
Downloads
453
Comments
3
Likes
1

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Medical/Legal and Ethical Issues
  • 2. Confidentiality
    • Confidential information
      • Pt. history
      • Assessment findings
      • Treatment rendered
    • Releasing confidential information
      • Written release signed from pt/legal guardian
    • Written release not needed…
      • Receiving facility,Transporting agencies
      • Continuation of care
      • 3 rd party billing info
      • Continuing education (remove pt ID)
      • Sate law (rape, abuse, GSW)
      • Subpoena
      • 12VAC5-31-950. Disclosure of patient information.
  • 3. Reporting Requirements
    • Vary from state to state
    • Abuse
      • Child
      • Elderly
      • Spouse/family
    • Crime
      • Wounds form violent crime
      • Sexual assault
    • Infectious disease exposure
    • Pt. restraint laws
    • Mentally incompetent
      • Intoxicated with injuries
  • 4. Scope of Practice What You Do…
    • “ Range of activities & limitations of a given medical provider”
    • Defined by state legislation
    • References national curricula
    • May be enhanced by
      • Medical direction
      • Protocols
      • Standing orders
    • Va OEMS Scope of Practce
  • 5. Standard of Care What You Know…
    • “ Body of knowledge, laws, policies, common practices, standards, and guidelines that provide the basis for prehospital care”
    • Defined by protocols and sate certification
  • 6. Negligence
    • “ Deviation from standard of care that results in HARM to the pt.”
    • 4 Elements of Negligence
      • Duty to act
      • Breach of duty
      • Damage
      • Causal connection
    • ALL 4 must be proven
  • 7. Components of Negligence
    • Duty to Act
      • “ Legal requirement to assess and treat a pt”
      • Est. pt-provider relationship
      • Implied
        • Pt calls for ambulance and one is sent
        • Treatment is started
      • Formal
        • Contracts
      • Off duty EMT has NONE
  • 8. Components of Negligence
    • Breach of Duty
      • “ Negligent action/omission that has violated the standards of care expected for an EMT under the circumstances”
        • Ex. Perform a procedure incorrectly
          • Failing to act in a timely/appropriate manner
          • Failing to act in the circumstances required
          • Performing other skills deemed negligent
  • 9. Components of Negligence
    • Damage
      • Physical
      • Psychological
    • No damage= No case
  • 10. Components of Negligence
    • Causal Connection
      • Clear connection from injury to EMT actions
  • 11. Abandonment
    • “ Termination of pt care without assuring the continuation of care at the same level or higher”
  • 12. Good Samaritan Laws
    • Protects volunteers from litigation
    • Raises bar
      • Negligence
      • Gross negligence
        • “ Willful & wanton recklessness that would be so careless as to be dangerous”
      • Va Good Samaritan Law
  • 13. Consent
    • MUST be obtained before treatment
    • Types
      • Expressed
      • Implied
  • 14. Expressed Consent
    • Verbal or other gesture
    • Characteristics
      • Informed of risks/benefits
      • Legal age
      • Rational decisions
      • Conscious
      • Mentally competent
  • 15. Implied Consent
    • “ Consent assumed from the unconscious pt requiring aid”
    • Assumes a reasonable person would expect emergency care in the situation
  • 16. Consent Special Cases
    • Children/Mentally incompetent people
      • Consent from legal guardian/parent
      • Treat as implied if none found
    • Emancipation
      • 16 years old and:
        • Married
        • In armed forces
        • Lives independently of parents
          • Financially self supporting
        • Is/was a parent
        • Code of Va § 16.1-331 - 334
  • 17. Refusals
    • Pt has right to
      • Refuse Care
      • Withdraw consent at any time
    • Pt must be
      • Mentally competent
      • Informed of risks/consequences
      • Sing “release of liability” form
        • Get a witness
    • Complete PPCR
      • Narrative
      • Advice given
      • Planned treatments
  • 18.  
  • 19. Complications of Refusals
    • False imprisonment
      • Transport pt against will
    • Assault
      • Creating fear of injury
    • Battery
      • Touching someone without their permission
  • 20. Do No Resuscitate (DNR)
    • DNR
      • Legal order signed by doctor
      • Withholds lifesaving measures in event of resp/cardiac arrest
      • HAVE TO SEE ORIGINAL
        • OTHERWISE
      • Treat the pt
      • MUST TRANSPORT WITH PT
    • Types
      • DNR Form
      • DNR jewelry
      • “ Other DRN”
        • Written order by doctor
    • Providers
      • Cannot recognize DNR from other states
      • Va Durable DNR Fact Sheet
  • 21. Advanced Directives
    • Advance Directive
      • Withhold certain care but not others
      • Specific to the pt.
    • Healthcare Proxy/POA
      • Legally empowered person other than pt
      • Makes medical decisions for pt
      • Mentally incompetent pt.
  • 22. Special Situations
    • Donor/Organ Harvesting
      • EMT role
        • ID pt as possible donor
        • Est. communication with medical direction
        • Provide care to maintain viable organs
      • Documentation
        • Donor card
        • Back of drivers license
  • 23. Special Situations
    • Medical ID insignia
      • Bracelets
      • Earrings
      • Charms/Pendants
      • Cufflinks
      • Ring
    • ID pt with medical problems
      • Allergies
      • Epilepsy
      • Diabetes
      • DNR status
      • Etc…
  • 24. Special Situations
    • Crime Scenes
      • Ensure personal/personnel/pt safety
      • Notify police via dispatch if 1 st responding
      • Don’t disturb items
      • Don’t cut through holes/stabs in clothing
      • Preserve chain of evidence
      • DOCUMENT!!!!!!
  • 25. Risk Management
    • SAFETY
    • Act according to Standard of Care
    • DOCUMENT!
    • Act in interest of the pt.
  • 26. Take a beak!