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At the completion of this lesson, each student should:
Know how to (from cognitive or knowledge information) . . .
1–3.1 Define the Emergency Medical Responder scope of care.
1–3.2 Discuss the importance of Do Not Resuscitate [DNR] (advance
directives) and local or state provisions regarding EMS
application. (pp. 27–28)
1–3.3 Define consent and discuss the methods of obtaining consent.
1–3.4 Differentiate between expressed and implied consent. (pp. 25–27)
1–3.5 Explain the role of consent of minors in providing care.
1–3.6 Discuss the implications for the Emergency Medical Responder in
patient refusal of transport. (pp. 24–25)
1–3.7 Discuss the issues of abandonment, negligence, and battery, and their
implications to the Emergency Medical Responder. (pp. 28–30)
1–3.8 State the conditions necessary for the Emergency Medical
Responder to have a duty to act. (pp. 28–29)
1–3.9 Explain the importance, necessity, and legality of patient
confidentiality. (pp. 30–32)
1–3.10 List the actions that an Emergency Medical Responder should take
to assist in the preservation of a crime scene. (pp. 33–34)
1–3.11 State the conditions that require an Emergency Medical Responder
to notify local law enforcement officials. (p. 32)
1–3.12 Discuss issues concerning the fundamental components of
documentation. (p. 34)
Feel comfortable enough to (by changing attitudes, values,
and beliefs) . . .
1–3.13 Explain the rationale for the needs, benefits, and usage of
advanced directives. (pp. 27–28)
1–3.14 Explain the rationale for the concept of varying degrees of DNR.
First Responder, Eighth Edition, Bergeron et al.
Chapter 2 Legal and Ethical Issues 15
Review the main points of Chapter 1, “Introduction to EMS Systems”
with the students. Explain that EMS systems are always evolving and
that effective EMS professionals never stop seeking ways to improve
their skills and knowledge. Encourage them to learn as much as they
can about their local EMS system and to see how they can help to
Distribute the scored quizzes from Chapter 1 and review each question. Clarify or address any concerns the students may have about the
CHAPTER 2 INTRO
Explain that as Emergency Medical Responders, your students are
going to be making some very important decisions when responding to
medical emergencies. It is critical that each person in the class understands the legal and ethical concepts that go into those decisions in
order to provide the best care possible for the patients and to protect
themselves and other responders.
Ask the following questions from the beginning of Chapter 2 in the
text and see what answers the class comes up with. (Don’t neglect the
opportunity to delve deeper into the answers and discuss the legal and
ethical questions highlighted by each question.)
• Should an off-duty Emergency Medical Responder stop to aid
victims of an automobile crash?
• Should you release information about a patient you cared for to
an attorney over the telephone?
• May a child with a suspected broken arm be treated, even if a parent is not present?
• What should happen when a patient who needs emergency medical care refuses it?
Conclude the introduction by having the students turn to the National
Standard Objectives and the Additional Learning Tasks in the beginning
of the chapter. Have them follow along as you explain each objective/task
and briefly answer any questions as needed.
The following suggested Presentation Outline is based on the First Responder,
8th Edition text. To further your students’ understanding of the subject,
watch for the symbol “‡” in the outline. It appears next to each topic that
can be expanded and discussed within the context of the chapter’s First on
I. LEGAL DUTIES
A. Scope of Care
B. Standard of Care
C. Ethical Responsibilities‡
First Responder, Eighth Edition, Bergeron et al.
16 Module 1 Preparatory
Chapter 2, Slides 3–5
POINT TO EMPHASIZE
At the beginning of this lesson,
make it very clear that laws differ
from state to state and that you will
explain any differences between
what the text may say and what is
true for your state. If possible, have
a local attorney visit to answer any
M02_BERG0597_08_SE_C02.QXD 5/12/08 1:39 PM Page 16
B. Refusal of Care
C. Expressed Consent‡
D. Implied Consent
III. DO NOT RESUSCITATE (DNR) ORDERS
VII. REPORTABLE EVENTS
VIII. SPECIAL SITUATIONS
A. Organ Donors
B. Medical Identification Devices
C. Crime Scenes
Review the chapter’s First on Scene scenario (pp. 21, 25, 32, and 34)
and then initiate a class discussion using the following questions.
Encourage the students to use their own life experiences and imaginations to provide answers.
▼ Topic 1: Have you ever been the first person on the scene of an accident like this? Were you (or would you be) apprehensive
about what you might find? Do you think it’s common for
emergency responders to be nervous when responding to
potentially bad collisions?
Although not all will admit it, most people—regardless of
time working in the EMS field—will feel apprehension when
arriving at a bad vehicle collision. Encourage the students to
share their feelings and make sure to emphasize that we are
all more alike than we are different and that most of the
others in the class will identify with what they are saying.
▼ Topic 2: Would it be tough to decide between taking the time to
check on the people in the collision (knowing that it may
further delay emergency personnel from responding to an
already isolated location) or to go to the nearest phone and
call for help (which may prove deadly to someone who needs
an airway opened or severe bleeding stopped)? What would
This should inspire a great conversation. There are very
compelling arguments for both sides of this issue. See if, by
discussing all sides, your class comes to the conclusion that
the most correct answer is actually a mix of the two answers
offered. It would be most appropriate to check for immediate
life threats and to then find a way to call for help. This is a
wonderful opportunity to compliment the students who came
to that conclusion because they were obviously thinking critically, not just trying to decide between the options offered.