EMT Basic · Chapter 3 · Review · Chapter track
Medical, Legal, and Ethical Issues
Referencing the content of EMT-Basic training and emergency patient care
Every patient contact touches consent, privacy, and documentation duties.
Learning objectives (16)
Compare expressed consent, implied consent, and involuntary consent — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Define consent and how it relates to decision making — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Define ethics and morality and their implications for the EMT — Knowledge/skills objective (printed page 86); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Describe local EMS system protocols for using forcible restraint — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Describe the EMT’s legal duty to act — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Describe the physical, presumptive, and definitive signs of death — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Describe the relationship between patient communications, confidentiality, and the Health Insurance Portability and Accountability Act (HIPAA) — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Describe the roles and responsibilities of the EMT in court — Knowledge/skills objective (printed page 86); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Discuss consent by minors for treatment or transport — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Discuss the EMT’s role and obligations if a patient refuses treatment or transport — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Discuss the importance of do not resuscitate (DNR) orders and local protocols as they relate to the EMS environment — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Discuss the issues of negligence, abandonment, assault and battery, and kidnapping and their implications for the EMT — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Discuss the scope of practice and standards of care — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Explain how to manage patients who are identified as organ donors — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Explain the reporting requirements for special situations, including abuse, drug- or felony- related injuries, childbirth, and crime scenes — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Recognize the importance of medical identification devices in treating the patient — Knowledge/skills objective (printed page 85); confirm wording in your course copy.
- HHS HIPAA for Professionals · U.S. HHS
- NM EMS scope guidance · NM DOH EMS Bureau
Chapter outline
- Consent: expressed, implied; capacity and decision-making; minors and surrogate decision-makers (overview; NM-specific rules from instructor)
- Refusal of care: informed refusal elements; documentation expectations; high-risk presentations
- Abandonment and continuity of care
- Negligence framework (duty, breach, harm); scope of practice as legal boundary
- Crime scenes: preservation, evidence awareness, law enforcement coordination at appropriate level for EMT-B
- Confidentiality and HIPAA concepts for EMS (minimum necessary, sharing for treatment, secure PCR)
- Ethical principles: autonomy, beneficence, nonmaleficence, justice; moral distress basics
- Advance directives and DNR / POLST-style orders (terminology and “verify and honor when applicable” workflow per protocol)
- Mandatory reporting categories (framework; NM lists from course materials)
- Special situations: organ donation notification awareness; forensic awareness without contaminating evidence
Chapter web resources
Optional reading from authoritative sites. Your textbook remains the primary source for this course.
- HHS HIPAA for Professionals · U.S. HHS
Privacy and minimum necessary disclosure
- NM EMS scope guidance · NM DOH EMS Bureau
Compare legal scope to your agency protocols
When sources disagree (5 topics to verify before you teach from this chapter alone)
Showing Chapter track material. Switch tracks on the chapter page.
Vocabulary · 18
Abandonment
Ending care without ensuring equivalent care or valid refusal process. Utilization: Avoid by transferring stable handoffs or staying until disposition is appropriate.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Advance directive
Written instructions about desired treatments when the patient cannot speak. Utilization: Honor when valid and applicable; coordinate with medical direction about scope limits.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Assault
Threat of unwanted touching or credible fear of harm; definitions vary by statute. Utilization: Documentation and law enforcement coordination per policy.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Battery
Unwanted touching of a competent patient without consent or valid exception. Utilization: Why consent processes matter even with good intentions.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Capacity
Ability to understand, appreciate, reason, and decide about care. Utilization: Core test for valid refusal.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Chain of custody
Documented control transfer for forensic items. Utilization: Preserve evidence integrity when crime scenes overlap EMS.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Consent
Permission for care from a patient with decision-making capacity. Utilization: Required for non-emergency touch and procedures when the patient can choose.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Duty to act
Legal or contractual obligation to respond and provide care within scope. Utilization: Varies by employment, licensure, and Good Samaritan statutes by jurisdiction.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Emancipated minor
Minor treated as adult for medical decisions per law. Utilization: Know jurisdictional rules affecting consent.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Expressed consent
Clear verbal or written agreement to treatment after adequate disclosure. Utilization: Typical model for alert adults who understand risks and benefits.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Good Samaritan laws
Statutes limiting liability for voluntary emergency aid in defined circumstances. Utilization: Read your state's conditions and scope limits.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
HIPAA
Federal privacy rule limiting disclosure of protected health information. Utilization: Share PHI only for treatment, operations, and legally permitted disclosures with minimum necessary.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Implied consent
Assumed permission when the patient cannot respond and urgent care is needed. Utilization: Basis for treating unconscious patients when delay would cause harm.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Informed refusal
Competent patient declines care after risks and alternatives are explained. Utilization: Requires capacity assessment, clear explanation, signed documentation per policy, and offered alternatives.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Mandatory reporting
Legal duty to report suspected abuse/neglect or certain injuries to authorities. Utilization: Know state lists (child, elder, intimate partner violence, gunshot rules) and agency policy.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Negligence
Breach of duty that causes harm when a prudent provider would have acted differently. Utilization: Prevent by following scope, protocols, thorough assessment, and good documentation.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
POLST
Portable orders about desired interventions in serious illness. Utilization: Coordinate with family and medical direction on applicability.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Slander / libel
Harmful false spoken or written statements. Utilization: Avoid defaming patients or agencies in public forums.
SourcePrinted pages 85–116. Emergency Care and Transportation of the Sick and Injured, 12th ed., Jones & Bartlett Learning / American Academy of Orthopaedic Surgeons (AAOS)
Sequences · 2
- Four elements of negligence — Order the elements a plaintiff must prove to establish negligence.
- Handling an informed refusal of care — Order the EMT's steps when a competent adult refuses transport.