Deck 4: Medicallegal and Ethical Issues

Question 1

Your patient is a 10-year-old boy who suffered a possible fractured arm while rollerblading at a friend's house.Which of the following is the BEST way to obtain consent for treatment?

A) Act on implied consent.
B) Get consent from the patient's 15-year-old sister, who is at the scene.
C) Call the patient's mother at work.
D) Allow the patient to consent as an emancipated minor.

Answer 1

Call the patient's mother at work.

Question 2

An off-duty EMT is driving down the road when she sees a major vehicle accident.There are no Emergency Medical Responders on the scene yet.There are only Good Samaritans.The EMT is late for a doctor's appointment so she decides that she will not stop and help.The driver of the vehicle dies before help arrives.One of the Good Samaritans notices her EMT license plates and writes them down as she passes by.The Good Samaritan is angry that the EMT did not stop and help and tries to get the EMT fired for not helping.Which of the following statements is true?

A) The EMT is negligent for not stopping and helping.
B) The EMT is negligent because the patient died.
C) The EMT is not negligent because she had a doctor's appointment.
D) The EMT is not negligent because she did not have a duty to act.

Answer 2

The EMT is not negligent because she did not have a duty to act.

Question 3

You respond to a middle school for a 12-year-old male patient who has been hit by a car.You get consent to treat the patient from the school principal.What concept allows the principal to speak for the parents?

A) In loco parentis
B) Informed consent
C) Res ipsa loquitur
D) Healthcare proxy

Answer 3

In loco parentis

Question 4

In which of the following situations should an EMT withhold resuscitative measures from a patient in cardiac arrest?

A) The patient's caregiver presents a DNR order signed by the patient and his physician.
B) The EMT's religious beliefs permit withholding resuscitation, and the caregiver presents documentation of the patient's wishes.
C) Family members request that nothing be done.
D) All of the above

Question 5

The EMT's obligation to provide care to a patient either as a formal or ethical responsibility is known as which of the following?

A) Legal responsibility
B) Scope of practice
C) Duty to act
D) Standard of care

Question 6

Your patient is a 40-year-old known diabetic who was found unconscious at work by a coworker.What type of consent allows you to treat this patient?

A) Consent for treatment of minor emergencies
B) Consent for mentally incompetent adults
C) Expressed consent
D) Implied consent

Question 7

You are on the scene with a 72-year-old male patient with chest pain.The patient is complaining of shortness of breath but also refuses to go to the hospital,even after multiple attempts urging him to go.Which of the following should you do next?

A) Stay with the patient until he loses consciousness.
B) Fully inform the patient about his situation and the implications of refusing care.
C) Inform the patient that he is having a "heart attack" and must be taken to the hospital for evaluation.
D) Contact medical direction for orders to restrain the patient.

Question 8

The administration of oxygen and the application of spinal immobilization is part of which of the following for the EMT?

A) Duty to act
B) Standard of care
C) Scope of practice
D) None of the above

Question 9

Which type of consent must be used by the EMT when seeking to treat a mentally competent adult?

A) Unconditional consent
B) Expressed consent
C) Conscious consent
D) Implied consent

Question 10

Sharing information about a patient's medical history with your neighbor after you hear a call on a radio scanner would constitute which of the following?

A) Slander
B) Violation of patient privacy
C) Breach of confidentiality
D) Libel

Question 11

Which of the following is NOT required to prove a claim of negligence against an EMT?

A) The EMT had a duty to act.
B) Proximate causation existed.
C) The EMT failed to act according to the standard of care.
D) The patient was in fear of bodily harm at the time of the incident.

Question 12

Which of the following statements is true concerning protection by Good Samaritan laws?

A) A Good Samaritan law allows an EMT to exceed the scope of practice, if necessary, when providing emergency care off-duty.
B) An EMT is expected to act as a lay person when providing emergency care off-duty.
C) The purpose of Good Samaritan laws is to protect people who are trying to help in an emergency.
D) An EMT cannot be sued for negligence if the state in which he works has a Good Samaritan law.

Question 13

Which of the following refers to the set of regulations that defines the legal actions expected and limitations placed on the EMT?

A) Scope of practice
B) Legal standards of practice
C) Protocols and standing orders
D) Professional standards

Question 14

In which of the following situations is it legal to share information about treatment you provided to a patient?

A) The triage nurse at the emergency department asks about the care you provided to the patient.
B) The patient gives verbal consent to release information to a friend.
C) The patient's lawyer requests the information over the phone.
D) You are asked by a coworker who knows the patient.

Question 15

Which of the following situations BEST illustrates the act of abandonment by the EMT?

A) The EMT resuscitates a patient who has a DNR order signed by his physician.
B) An EMT transports a patient to the emergency department, leaves the patient in the waiting room, but does not advise the ED staff.
C) An EMT begins care of a patient, then turns the patient over to a paramedic.
D) An EMT who is off-duty sees a motor vehicle collision with probable injuries but does not stop to help.

Question 16

Your patient is a 45-year-old man who is suffering from chest pain.Upon arrival,the patient is pale,sweaty,and seems short of breath.The patient is angry with his daughter for calling 911.He says that he had some spicy sausage for breakfast and has indigestion.Which of the following is an appropriate means of getting the patient the care he needs?

A) Try to find out why the patient does not want to go to the hospital.
B) Call the patient's neighbors and tell them that you have been called to the patient's house but he is now refusing care.
C) Inform the patient that if he does not agree to treatment, you will have to take him against his will because he has a potentially life-threatening problem.
D) Tell the patient that his chest pain is most likely caused by his diet, have him take an antacid, and go to bed.

Question 17

You arrive on the scene of a 55-year-old male patient.The patient's wife called 911 because he is having chest pains.The patient is very angry with his wife for calling 911 because he states he only has heartburn and adamantly refuses any treatment or transport.After signing the patient refusal form,the patient collapses and goes into sudden cardiac arrest.The wife is crying uncontrollably and begging you to do something.What should you do?

A) Respect his legal right to not have any treatment, regardless of how much the wife begs you to help.
B) Explain to the wife that her husband signed a legal document refusing care, and if you intervened to help him now, you would be breaking the law.
C) Provide emergency care for the patient only if his wife signs a document stating they will not sue the EMS service.
D) Provide emergency care under implied consent.

Question 18

Two EMTs respond to the scene of a syncopal episode.They evaluate a 50-year-old male patient who passed out and cut his upper lip.The EMTs examine the patient and his vital signs are normal.The EMTs talk the patient out of an expensive ambulance ride and suggest he will save money by driving himself to the urgent care clinic for stitches for his lip rather than waiting all night in the emergency department as a nonemergency patient.The patient signs the EMS refusal form.The patient decides to see his own doctor the next morning but dies at his house from sudden cardiac arrest an hour later.Which of the following statements is true?

A) The EMTs are not negligent because the patient signed the refusal form.
B) The EMTs are negligent because the patient died.
C) The EMTs are negligent because there was proximate causation.
D) The EMTs are not negligent because the EMTs have no control over the patient's medical condition.

Question 19

If the EMT is in doubt as to whether a patient in cardiac arrest should be resuscitated,which of the following is the best decision?

A) Have the patient's family put their wishes in writing.
B) Withhold resuscitative measures.
C) Consult with the patient's physician.
D) Begin resuscitative measures.

Question 20

Which of the following refers to the care that would be expected to be provided by an EMT with similar training when caring for a patient in a similar situation?

A) Scope of practice
B) Standard of practice
C) Protocols and standing orders
D) Professional standards

Question 21

You are providing care to a 54-year-old male patient complaining of chest pain.The patient asks to speak to you privately.He tells you he is taking Cialis® for erectile dysfunction and his wife does not know he is taking it.He does not want his wife to find out.As you are putting the EMS bags back in the ambulance,the wife corners you and insists that you tell her what her husband said.What should you do?

A) You should tell her. As his spouse, she is legally entitled to know his medical information.
B) You should not tell her. There is no reason to humiliate your patient by disclosing his embarrassing condition.
C) You should tell her. He may be having an affair without her knowledge and she needs to be tested for sexually transmitted diseases.
D) You should not tell her. By law, your conversation with your patient is confidential.

Question 22

You respond to the report of an unconscious female patient.You can acquire important medical information about the patient through which of the following?

A) Medical identification device
B) Driver's license
C) Medical history identifier
D) On-call Medical Director

Question 23

Which of the following is the EMT's primary responsibility at a secured crime scene?

A) Identifying any potential suspects encountered at the scene
B) Providing patient care
C) Taking notes that may be needed during court testimony
D) Preserving evidence

Question 24

While treating a patient involved in a shooting at the patient's vacation home,which of the following actions may interfere with the investigation of a crime scene?

A) Moving the patient
B) Using the bathroom
C) Using the patient's phone
D) All of the above

Question 25

You are treating an elderly male patient in the back of your ambulance.En route,the patient becomes unresponsive.Upon arrival,the ED nurse asks you several questions about his condition.What should you do?

A) You should answer her questions because you may legally share the patient's medical condition with other pertinent health care providers.
B) You should not disclose the information to the nurse because it is protected confidential information and the patient did not sign a release authorizing you to discuss his condition.
C) You should not disclose the information because HIPAA laws only allow you to provide the information to the emergency department physician.
D) You should disclose the information, as it is not protected by law.

Question 26

Which of the following information may be important to law enforcement officers investigating a crime scene?

A) What route you took when responding to the scene
B) How you gained access to the scene
C) Your opinion of what happened before you arrived on-scene
D) Your experience as an EMT

Question 27

Which of the following incidents is the EMT legally required to report to law enforcement?

A) You suspect the wife of the patient you are treating for chest pain has been smoking marijuana.
B) Your patient is an 18-year-old college student who has been consuming large amounts of alcohol at a fraternity party.
C) Your patient is a 12-year-old male who fell from his bicycle, breaking his left arm, and tells you his parents are at work.
D) Your patient has facial and head injuries and states that her husband beat her with a telephone receiver.

Question 28

You respond to a bus accident with multiple patients.As you arrive at the scene,you are approached by a local politician who states that his wife has been involved.He tells you that if you will take care of her first,he will ensure that you get the promotion you are up for.This becomes what type of decision for you as an EMT?

A) Legal
B) Financial
C) Medical
D) Ethical

Question 29

Which of the following requires training,policies,and procedures related to storing,accessing,and sharing patient information?

A) HIPAA
B) HIAPA
C) EMTALA
D) COBRA

Question 30

While documenting a call,you add a false statement that was made about a local doctor.This could constitute which of the following?

A) Libel
B) Slander
C) Degradation of character
D) HIPAA violation