Medical Legal Aspects Ppt

103 Summary orders for do not resuscitate define the care a patient wishes to receive when life-saving procedures are required. Paramedics need to become familiar with the decisions their patients have made regarding medical care and treatment issues. Paramedics must deal with futile resuscitation before an emergency event. The laws of the Good Samaritan protect the physician who provides care outside of service. 2 National EMS Education Standard SkillsPreparatory Integrates in-depth knowledge of the EMS system, paramedic safety and well-being, and medical, legal, and ethical issues designed to improve the health of EMS staff, patients, and the community. Patient confidentiality • By law, all personal health information must be kept confidential – privileged disclosure. • Patients share private information with healthcare providers. They are required to respect the patient`s trust and keep this information secret. • This requires restricting others` access to private information. 9 Medical ethics Medical ethics refers to the practice and delivery of medical care. Your understanding of medical ethics must conform to the codes of your profession. Medical law • In the context of health care, a number of legal issues may arise.

• Everything is connected: law, risk management and ethical issues. • The law is dynamic – constantly evolving. Case #2 • The husband insists that the patient did not intend the document to be used in such a situation. • He believes that his condition is not fatal, although it is not able to restore significant brain function. • The husband is not willing to withdraw life-sustaining measures that correspond to the patient`s wishes. •What to do? • What are the legal implications? 51 Minors Obtaining parental consent. In loco parentis, if the guardian is not available, notify law enforcement and medical control if a parent refuses the necessary treatment. The State may take custody Case #1 – Discussion • Informed consent and substitute decision. • The patient`s own statements/consents can serve as a basis for ongoing care. • It is likely that an interim court order is in effect that could prevent the ex-husband from making medical decisions for her. May also have an injunction.

• The health facility may contact the divorce attorney to obtain the appropriate documents. 83 Americans with Disabilities Act (ADA)Employers can only inquire about disabilities or require a medical exam after the job offer is made. Reasonable accommodation must be made. Employers are not obliged to give preference to disabled workers. 104 Summary State immunity can protect the paramedic who is not negligent. Limitation period and contributory negligence are two common legal defences. The relationship between paramedics and their employers is affected by federal and state laws. Breach of contract • A contract is an agreement between two or more parties. • Offer, acceptance, consideration. • Breach of contract – failure to fulfill a promise or perform any of the terms of a contract without legal excuse. • For the contract to be valid, both parties must be legally capable/free from legal incapacity. • Contracts can be express (oral or written) or tacit (without verbal clauses).

52 minors Emancipated minors Obtaining consent is a difficult skill. Treating like an adult due to qualified circumstances Obtaining consent is a difficult skill. Your expertise will accumulate over time. Patient responsibility • The collaborative nature of health care requires that patients and/or their families be involved in care. • Patients have both rights and obligations. • Provide information about medical history. • Participation in decision-making. • Request information and/or clarification if they do not fully understand. 35 Emergency Medical Treatment and Active Work ActEMTALA Founded to fight “patient dumping” Never make decisions based on finances.

Know local transportation selection protocols. Guaranteed medical examination and treatment Regulates patient transfers © Gary Kazanjian/AP photos 53 Violent patients and restrictionsYou can only use violence against yourself in response to a patient`s violence. Don`t get into a dangerous scene. Only detain medical patients who pose a danger to themselves or others. © Jack Dagley Photography/ShutterStock, Inc. 25 The Paramedic and Medical DirectorMany paramedic activities require instruction from a doctor. Online or offline If conflicts arise, the online medical check should resolve them. Not the case of paramedic #1 • The patient`s parents are vigilant at her bedside.

• Parents report that the patient is 1 month away from final divorce. • The husband was allegedly physically and emotionally abusive. • No one warned the husband. • Who is responsible for treatment decisions that the patient cannot make? • What are the legal and ethical parameters? Documentation • All documents must be signed with the name and title of the person recording the information. • The date and time of creation of the documentation must also be recorded. • Errors must be clearly crossed out with a straight line, “errors” must be recorded by them and show the initials of the person making the mistake. • Documentation cannot be your opinion or interpretation. All observations should be reported as subjective or objective information. • Patient documentation is an admissible legal record in court. 84 Title VII of the Civil Rights Act prohibits discrimination on the basis of race, color, religion, sex, and national origin Also prohibits sexual harassment Applies to all aspects of employment Usually a trend over time, not a single incident Medical law • General medical law: • Access to medical care • Informed consent • Confidentiality of information • Privileged communication • Advanced policies • Medically committed suicides assisted • Medical errors 98 Summary Failure to report certain cases may result in prosecution. Certain types of deaths must be reported to local law enforcement.

Paramedics cannot violate the privacy, consent and rejection of sane patients. The only protection against a civil action for refusal is documentation. Introduction • Health care workers should be aware of and follow state laws that govern their respective licenses or registrations or set standards for their respective professions. • Failure to comply with your legal obligations may result in legal action being taken against you and your employer. • Use problem-solving techniques when faced with legal dilemmas or problems. Case #2 • A 72-year-old woman admitted to the neurocritical care unit after a brain hemorrhage left her with severe brain damage and ventilators. • The patient and her husband had previously drawn up a living will stating that she did not want artificial life support in the event of an incurable illness or permanent vegetative state. • The patient`s husband is the next of kin – has the decision-making power of the surrogate. 24 Paramedic and Medical DirectorThe Act may require a Medical Director. Supervises paramedic Paramedic Paramedic is not Medical Director Agent may issue corrective action Not responsible for disciplinary action 97 Summary EMTALA prevents hospitals from turning away patients.

The use of emergency vehicles must be carried out safely. A patient`s transportation depends on their preferences and medical needs. Paramedics must obtain evidence and document their actions at a crime scene. 58 Elements of negligenceDuty (continued) Must meet a standard of care to provide assistance Cannot leave the patient once care begins Must maintain license or certification and capabilities EMS systems may be subject to a legal obligation. 47 Decision-makingPatients who refuse treatment are not “bad”. I can not admit that there is a problem Let the patient talk to the medical control. Maintain a polite and friendly attitude. Documentation is crucial. Art. 46 Decision-making capacityIf a conscious patient with decision-making capacity refuses treatment: cannot be treated without a court order See the medical report.

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