Legal And Regulatory Issues

the theory and philosophy of law

defined by statutes and regulations and are based on generally accepted standards.

A law passed by legislature.

moral principles based on societal standards that identify desirable conduct.

-Being dedicated to the professio of paramedicine.

-Treating patients with dignity and respect.

-Being obliged to care for the physical and emotional needs of pt's.

-Maintaining and mastering clinical skills.

-Participating in continuing education and refresher training.

-Critically reviewing your performance and continuously seeking to improve your care.

- Reporting honestly

-Respecting privacy and confidentiality of patients

-Working cooperatively and with respect for other emergency professionals

-Respecting the wishes and desires of pt's

includes, for example, Congress and the state legislatures. This branch is the source of statutory law.

Statutes and ordinances enacted by the U.S. Congress, state legislatures, and city councils.

includes state and federal courts. This branch is the source of case law.

Interpretations of constitutional, statutory, or administrative law made by the courts; also referred to as common law or judge-made law.

includes the state governors and the administrative agencies that make regulations. This branch is the source of administrative law.

A branch of the law that deals with rules, regulations, orders, and decisions created by government agencies.

determines the outcome of individual cases in the legal process. Cases may be decided by a judge or jury.

has the power to review the decisions by trial courts or other appeals courts. Decisions made by an appellate court may set precedent for later cases bases on similar legal issues and facts.

The regulation of paramedic practice at the local level generally consists of ordinances, rules, regulations, or protocols. These items concern issues such as response times, clinical practice, and patient destination.

At the state level, paramedic practice is typically regulated by law and regulations that deal with the certification or licensing of providers, ambulance serves licensing, provider scope of practice, handling and storage of controlled substance, disciplinary enforcement, and related issues. DNR's/advanced directives

-highly technical and complex laws and regs.

-reimbursement for services (Medicare)

-Privacy and confidentiality (HIPPA)

-Pt destination and hospital diversion (the Emergency Medical Treatment and Active Labor Act)

administrative law

civil law

criminal law

consists of rules and regulations that come from governmental agencies, such as a state EMS office, or a federal agency, such as the Centers for Medicare and Medicaid Services (CMS).

establishes reimbursement policy and regulations.

The right of the governmental agency to create rules and regulations results when a legislative body (U.S. Congress, state legislature, or city counsel) passes a statutory law that gives an agency the right to created rules and regulations (administrative law) that govern a particular activity.

The constitutional guarantee that laws and legal proceedings must be fair regarding an individual's legal rights.

A branch of law that deals with torts (civil wrongs) committed by one individual, organization, or group against another.

The person who initiates a lawsuit by filing a complaint; also known as a claimant, petitioner, or applicant.

The person or institution being sued; also called the respondent.

A wrong committed on the person or property of another.

A branch of law in which the federal, state, or local government prosecutes individuals on behalf of society for violating laws designed to safeguard society.

In state courts. The case is first heard by a state trial court. An appeal may be reviewed by state courts of appeal and, finally, the supreme court of the state.

A predefined set of skills, interventions, or other activities that the paramedic is legally authorized to perform when necessary; usually set by state law or regulation and local medical direction.

What you legally can and cannot do as a paramedic.

National Highway Traffic Safety Administration

Conduct exercising the degree of care, skill, and judgment that would be expected under like or similar circumstances by a similarly trained, reasonable paramedic in the same scenario.

Physician oversight of paramedic practice; also called medical control.

Physician development of standards such as training curricula and protocols that establish, in advance, the parameters of EMS practice and set forth the expectations that EMS providers must satisfy in the delivery of patient care.

Consultation with a physician or other advanced healthcare professional by telephone, radio, or other electronic means, permitting the physician and paramedic to decide together on the best course of action in the delivery of patient care.

Physician oversight that evaluates the effectiveness of care given through quality improvement programs, case reviews, and similar approaches.

Recognition of minimal competency and the completion of prescribed education or training in a profession or occupation.

Recognition of minimal competency in certain skills or tasks.

legislation that governs the practice of medicine; may prescribe how and to what extent a physician may delegate authority to a paramedic to perform medical acts; varies from state to state.

The legal responsibility of a party for the consequences of his or her acts or omissions.

A type of tort case addressing whether a professional person failed to act as a reasonably prudent and careful person with similar training would act under similar circumstances.

The failure to act as a reasonably prudent and careful person would under similar circumstances.

A law that sets the time limits within which parties must take action to enforce their rights.

A wrong that the defendant did not mean to commit; a case in which a bad outcome occurred because of the failure to exercise reasonable care.

An injured plaintiff's failure to exercise due care that, along with the defendant's negligence, contributed to the injury.

1. Duty

2. Breach of duty

3. Damages

4. Causation

A legal obligation (created by statute, contract, or voluntarily) to provide services.

Violation by the defendant of the standard of care applicable to the circumstances.

Performing a wrongful act

Performing a legal act in a harmful manner.

Failure to perform a required act or duty.

- Scope of practice

- EMS protocols

- Applicable EMS policies or procedures

- National standard curriculum

- Literature (journals, EMS textbooks)

- Expert witnesses

- Juries

Conduct that may be declared and treated as negligent without having to prove what would be reasonable and prudent under similar circumstances, usually because the conduct violates a law or regulation.

latin parse meaning "the thing speaks for itself." In negligence cases, this doctrine can be imposed when the plaintiff cannot prove al four components of negligence, but the injury itself would not have occurred without negligence (such as a sponge left in a patient after surgery).

Compensable harm or other losses incurred by an injured party (plaintiff) because of the negligence of the defendant.

In a negligence case, the negligence of the defendant must have caused or created the harm sustained by the plaintiff; also referred to as proximate cause.

Protection from legal liability in accordance with applicable laws.

a judge

wrongs in which the defendant meant to cause the harmful action.

-Assault

-Battery

-False Imprisonment

-Invasion of privacy

-Libel

-Slander

Touching or contact with another person without that person's consent.

A threat of imminent bodily harm to another person by someone with the obvious ability to carry out the threat.

Confinement or restraint of a person against his or her will or without appropriate legal jurisdiction.

Disclosure or publication of personal or private facts about a person to a person or persons not authorized to receive such information.

False statements about a person made in writing that blacken the person's character or injure his or her reputation.

False statements spoken about a person that blacken the person's character or injure his or her reputation.

The publication of false information about a person that tends to blacken the person's character or injure his or her reputation.

slander is spoken form

libel is the written form

Latin phrase meaning "let the master answer." Under this legal doctrine, an employer is liable for the acts of employees within their scope of employment.

informed permission, for care and/or transportation by EMS providers.

Permission given by a patient or his or her responsible decision maker either verbally or through some physical expression of consent.

The patient or responsible decision maker must be properly informed about the following:

-Nature of the illness or injury

-Treatment recommended

-benefits of treatment

-risks and dangers of treatment

-Alternative treatment possible and risks

-Dangers of refusing treatment (including transport)

The presumption that patient who is ill or injured and unable to five consent fro any reason would agree to the delivery of emergency healthcare necessitated by his or her condition.

The rendering of care to a person under specific legal authority, even if the patient does not consent to the care.

A federal law that requires a hospital to provide a medical screening examination to anyone who comes to that hospital and to provide stabilizing treatment to anyone with an emergency medical condition, without considering the patient's ability to pay.

In most states, a person younger than 18 years.

A self-supporting minor. This status often depends on the minor receiving an actual court order of emancipation.

means "parent of the country."

-school officials

-state guardian

-governmental child services

Government agencies can give consent for minors under this concept.

-A record of the patient's mental status

-Findings of the paramedic's assessment of the patient

-Details about any potential MOI or NOI

-Specific risks discussed with the patient and the patient's understanding of those risks

-Involvement of any medical direction in the refusal

-Signature of patient or legally responsible decision maker on refusal of care form that includes a release of liability.

Terminating care when it is still needed and desired by the patient and without ensuring that appropriate care continues to be provided by another qualified healthcare professional.

Protection of patient information in any form and the disclosure of that information only as needed for patient care or as otherwise permitted by law

treatment

payment

healthcare operations

-name -Health plan beneficiary number

-Address -E-mail address/Web site

-Employer -SSN

-Relatives' names -Medical record number

-Dates relating to pt -Employee or account#

-Phone and fax#'s -Vehicle or device #'s

-Finger or voice print -License numbers

-Photograph -Any unique identifier of code

-They must be used cautiously

-They must be used consistently with any applicable protocols

-They must be used in a way that protects the patient and preserves his or her dignity to the maximal extent possible.

Straps, splints, and other devices that prevent movement of all or part of the patient's body.

Agents such as sedatives that can suppress a patient's neurologic and / or motor capabilities and reduce the threat to the paramedic.

legislation that governs the practice of medicine; may prescribe how and to what extent a physician may delegate authority to a paramedic to perform medical acts; varies from state to state.

a minimum of four providers (one for each extremity)

-destination of transport

-the time of arrival

-the pt's condition on arrival

-address to which you responded

-The time of arrival

-survey of the scene or search of area

-other related details

A document in which a competent person gives instructions to be followed regarding his or her healthcare in the event the person later becomes incapacitated and unable to make or communicate those decisions to others.