Health Science Core Chapter 4

The Allied Health Worker, the Law, and Professional Ethics

McFatter Technical Center

Emergency Medical Technician - Basic

Patient Trust

• Patient advocate – individual who supports and pleads the cause of the patient.

• Scope of practice – legal description of what a specific health professional may and may not do.– State Statutes – written laws – Not legally permitted to perform outside the

training level– Medical Director defines the scope of EMTs

with standing orders (protocols) or direct communication (radio)

Standard of Care

• Manner in which you must act or behave• Standard imposed by local customs – how a

prudent person with similar training and experience would act under similar circumstances with similar equipment and in the same place.

• Standard imposed by law – standards of medical care imposed by statutes, ordinances, administrative regulation, or case law.

Standard of Care

• Professional or Institutional Standards – standard imposed by law, professional, or institutional.– Professional – published by organizations

involved in EMS– Institutional – Your EMS service rules and

regulations

Ethics

• Ethics – principles of conduct that establish standards and morals that govern decisions and behavior.

• Ethical decisions involve integrity, honesty, and a strong sense of right and wrong.

• EMS code of Ethics

Duty to Act

Individual responsibility to provide patient care

• Respond to a call or treatment begins

• Off duty responsible to act if you identify yourself as an EMT

Contractual Relationships

• Contract implies everyone involved has agreed to do something.

• Breach of contract:– Duty to act – legal duty to provide care to a

patient within his or her legal scope of practice

– Relevance – relevant to the subject matter– Compensation – Payment for services– Mutual agreement – both parties agree on

services

Requirements for breach of contract lawsuit

• Duty to act – legal duty to provide care• Breach of duty to act – omission of care• Proximate cause – aspect of care that

was omitted or committed directly caused a patient’s injury or death.

• Damages (recoverable) – degree of loss that has occurred due to injury to person, property, or reputation.

Common Healthcare Lawsuits

• Negligence – failure to give reasonable care or to do what another prudent person with similar experience, knowledge, and background would have done under the same or similar circumstance.

• Malpractice – professional misconduct or lack of professional skill that results in injury to the patient.

Types of Intentional torts (Negligence)

• Battery – unlawful touching of an individual without consent

• Assault – threat of immediate harmful or offensive contact without commission of the act

• False imprisonment – restraining a person against his or her will, either physically or verbal threats.

• Abandonment – termination of supervision of a patient without patient’s consent

• Invasion of privacy – public discussion of private information without patient’s written consent (See HIPPA laws).

• Defamation of character – discussion of a person by another either in writing or verbally that damages that person’s reputation.

• Fraud and misrepresentation – intentional withholding of information from a patient to cover up mistakes

Types of Intentional torts (Negligence)

Consent

• Patient must give permission for treatment. Not obtaining consent could be ground for criminal and civil action for assault and battery.– Expressed consent – actual consent– Implied consent – patient is unconscious and

unable to give consent when serious threat to life and limb, but it is assumed they would give consent

Minor Consent

Only parent or legal guardian can give consent. Minor are

not able to give consent. Except:

• Emancipated • Married• Pregnant

Right to Refuse Treatment

• Must make sure the patient understands• Must inform potential risks, benefits, treatments,

and treatment alternative• Must document refusal of care, patient or

guardian sign acknowledgement, and get witnessed signature

Baker ActFlorida Statue Chapter 394.463

Mental Health relates to authorization of police,

physicians and the courts to dictate certain medical care

for persons who pose a threat to themselves or

others

Incapacitated Person Act Florida Statue Chapter 401.445

Allows for the examination / treatment of an incapacitated person in an

emergency.– Intoxicated– Under Influence of Drugs– Incapable to provide Consent

Good Samaritan Laws and Immunity

• Protects good Samaritan from liability for errors and omissions that are made in giving good faith emergency care.

• Any one can be presented with a lawsuit• Good Samaritan law provides a defense• Do not protect:

– Gross or willful negligence– Failure to provide proper care outside the

scope of care

Advance Directives:Do Not Resuscitate Orders (DNRO)

• State of Florida on standard form DH Form 1896

• Legal document that provides advance direction on withholding care

Florida DNRO Acceptable Identification

• Original Yellow DH Form 1896 with original signatures

• Copy on Yellow Paper DH Form 1896 with Original Signatures

• Wearing Bracelet, but must provide Original DH Form 1896.

Not AcceptableLiving wills and oral orders from non-Physician

staff members

Florida DNRO Confirming Patient with DNRO

• EMT must confirm identity of patient:1. Drivers license

or2. Photo Identification

or 3. Witness

• Must document on report the following with witnesses:1. Full Name of witness2. Address and phone number 3. Relationship of witness to patient

Confidentiality

• Communication between you and the patient is considered confidential. Including:– Patient history– Assessment findings– Treatment provided

• HIPPA – Health Insurance Portability and Accountability Act of 1996 – patient privacy rights

HIPAA Law – Main Goal

• Assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well being.

• Strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing.

HIPAA Law – Information Protected

“Individually identifiable health information” is information,

including:• the individual’s past, present or future

physical or mental health or condition• the provision of health care to the

individual• the past, present, or future payment

for the provision of health care to the individual

References

• Pollak, Andrew N. Emergency Care and Transportation of the Sick and Injured. 9th ed. Sudbury, Massachusetts: Jones and Bartlett, 2005.

• Stevens, Kay, and Garber, Debra. Introduction to Clinical Allied Healthcare. 2nd ed. Clifton Park, New York: Thomson Delmar Learning, 1996.