AEMCA Medicolegal and Ethical Issues 2 — Questions and Answers
Question 1: A patient with a valid Do Not Resuscitate (DNR) order goes into cardiac arrest. What is the AEMCA's appropriate action?
- Initiate CPR regardless of the DNR
- Honor the DNR and withhold resuscitation (Correct answer)
- Contact medical direction before making any decision
- Attempt resuscitation until family members arrive
Correct answer: Honor the DNR and withhold resuscitation
A valid DNR order is a legal document that must be honored; withholding resuscitation respects the patient's documented wishes.
Question 2: Which of the following best describes the legal concept of 'abandonment' in EMS?
- Failing to obtain informed consent before treatment
- Terminating care without ensuring an equal or higher level of care takes over (Correct answer)
- Refusing to transport a patient to their preferred hospital
- Leaving a scene before law enforcement arrives
Correct answer: Terminating care without ensuring an equal or higher level of care takes over
Abandonment occurs when a provider unilaterally terminates care without transferring responsibility to an equally or more qualified provider.
Question 3: When is it legally permissible for an AEMCA to disclose patient information to law enforcement without patient consent?
- Whenever an officer requests it on scene
- When the patient is a minor
- When required by mandatory reporting laws such as for gunshot wounds (Correct answer)
- Any time the patient is unconscious
Correct answer: When required by mandatory reporting laws such as for gunshot wounds
Mandatory reporting laws legally require disclosure of specific information such as gunshot wounds, stab wounds, and suspected abuse to law enforcement.
Question 4: An AEMCA documents in the patient care report that a patient was 'intoxicated and uncooperative' without objective clinical findings. This documentation could create liability for:
- Battery
- Defamation (Correct answer)
- Negligence
- False imprisonment
Correct answer: Defamation
Documenting subjective characterizations without clinical basis can constitute defamation if the statements damage the patient's reputation.
Question 5: A competent adult patient refuses transport after a motor vehicle collision. To protect against liability, the AEMCA should:
- Leave immediately and document the refusal briefly
- Have the patient sign a refusal form after explaining risks and benefits (Correct answer)
- Contact law enforcement to compel transport
- Advise the patient they have no right to refuse emergency care
Correct answer: Have the patient sign a refusal form after explaining risks and benefits
A signed informed refusal form that documents the patient's understanding of risks protects the AEMCA against future liability.
Question 6: Which ethical principle obligates the AEMCA to avoid causing harm to the patient?
- Autonomy
- Beneficence
- Non-maleficence (Correct answer)
- Justice
Correct answer: Non-maleficence
Non-maleficence is the duty to 'do no harm' and requires providers to avoid actions that could injure or worsen the patient's condition.
Question 7: An AEMCA is called to a scene where a patient's family member claims to hold power of attorney. In an emergency, the AEMCA should:
- Only follow instructions from the power of attorney holder
- Treat the patient under implied consent while verifying the POA's scope with medical direction (Correct answer)
- Refuse treatment until legal documentation is physically reviewed
- Always defer all decisions to the family member present
Correct answer: Treat the patient under implied consent while verifying the POA's scope with medical direction
In true emergencies, implied consent allows treatment while the validity and scope of a POA are clarified through medical direction.
AEMCA Medicolegal and Ethical Issues 2
A patient with a valid Do Not Resuscitate (DNR) order goes into cardiac arrest.
What is the AEMCA's appropriate action?