Health Science Core Chapter 4 The Allied Health Worker, the Law, and Professional Ethics

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Health Science Core Chapter 4 The Allied Health
Worker, the Law, and Professional Ethics
McFatter Technical Center Emergency Medical
Technician - Basic
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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)

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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.

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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

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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

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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

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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

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

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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.

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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 patients consent

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Types of Intentional torts (Negligence)

• Invasion of privacy public discussion of
  private information without patients written
  consent (See HIPPA laws).
• Defamation of character discussion of a person
  by another either in writing or verbally that
  damages that persons reputation.
• Fraud and misrepresentation intentional
  withholding of information from a patient to
  cover up mistakes

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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

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Minor Consent

• Only parent or legal guardian can give consent.
  Minor are not able to give consent. Except
• Emancipated
• Married
• Pregnant

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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

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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

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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

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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

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Advance DirectivesDo Not Resuscitate Orders
(DNRO)

• State of Florida on standard form DH Form 1896
• Legal document that provides advance direction on
  withholding care

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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 Acceptable
• Living wills and oral orders from non-Physician
  staff members

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Florida DNRO Confirming Patient with DNRO

• EMT must confirm identity of patient
• Drivers license
• or
• Photo Identification
• or
• 3. Witness
• Must document on report the following with
  witnesses
• Full Name of witness
• Address and phone number
• Relationship of witness to patient

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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

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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.

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HIPAA Law Information Protected

• Individually identifiable health information is
  information, including
• the individuals 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

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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.