Paper Example on Ambulance Staff Must Adhere to Informed Consent Requirements

Assignment 1:

All the staff of the ambulance service will be required to adhere to the need for informed consent, which is a cardinal requirement in the provision of medical care. Adherence to this principle will enable the patients to make their own medical decisions based on their knowledge. The need for informed consent applies even to the emergency medical service providers, so all staff will be required to use it in their work. However, certain circumstances may make the need for informed consent unnecessary.

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The principle of informed consent applies to cogent adults. However, an adult can refuse all manner of medical treatment even if they are in life-threatening conditions. They have this right, and it falls under the right to privacy (Nicholson, 2012). In such a situation, the staff have no other duty but to let the adult bear the consequence of their choice.

However, if the adult is deemed to be mentally unfit to make sound medical decisions, informed consent may be assumed. Under these circumstances, the physician should go ahead and offer the necessary treatment to the adult without consent from a parent or guardian.

It is also vital that the staff consider some fundamental issues regarding informed consent.

The team has to sufficiently inform the patient of the critical questions regarding the provision of care. The patient has to be given the information on the diagnosis, nature of the proposed treatment, and the alternative medical procedures available to them. At the same time, the physician should make the patient know the consequence of refusing the treatment. The whole explanation needs to be done in a language that the patient understands.

Court case: A 72-year-old mentally sound man had a medical condition that remained untreated for long and spread gangrene to both of his legs. The state threatened his life, and upon admission to the ED, he refused to consent to any treatment even though he was in imminent danger of death (Liang & Moore, 2003). The hospital applied for a court case to compel the patient to have the necessary treatment. The court held that the hospital could not force the procedure on the patient even though it was life-threatening.

Minors who are in an Apparent Life-Threatening Condition

The staff will conduct the treatment of the child without obtaining any consent from a person in charge because of the fatal disease. The potential harm to the child if the medical attention is not offered has to be evident for this exception to apply; otherwise informed consent has to be obtained.

The staff will rely on the Emergency Medical Treatment and Labor Act (EMTALA), which voids the laws of any state and demand that medical screening and stabilization of pediatric patients is done (Nicholson, 2012). Under these circumstances, medical assistance is offered without the need for parental or guardian consent.

The staff of the ambulance service will also consider situations in which the principle of the 'mature minor' can apply. Under such a condition, a mature minor provides his consent in case of an emergency without the need for parental or guardian consent. The staff will have to ascertain that the child in such a situation is of appropriate age and maturity. They should be capable of understanding the nature of the emergency, the prescribed treatment, and the existing alternatives.

States have different requirements regarding the consent of minors in life-threatening situations. Consequently, the staff will have to familiarize themselves with the provisions of various state laws to operate effectively.

Court case: A 17-year-old was involved in a life-threatening accident on a rail track after he tried to jump from the moving train but got caught in the iron step and was dragged for about 80 feet (Liang & Moore, 2003). On arrival at the hospital, he was found to have crushed the elbow and had a three-inch laceration that was bleeding profusely.

In the operating room, the boy was anesthetized, and the doctors determined that he needed an amputation of the arm to save his life. After the amputation, recovery, and discharge, the parents and the child brought a charge against the doctors that they did not give their consent to the procedure. The courts held for the defendants that the process was necessary to save the minor's life.

Minors whose Condition is not Life-Threatening

In such non-emergent situations, informed consent has to be obtained for treating the child just like in the case of an adult. The parent or guardian is to give consent on behalf of the minor child. The staff should spare no effort to get informed consent from the guardian or parent of a minor, even if the law allows for the treatment without getting it. Such an effort will help the department to avoid issues that arise out of a medical procedure such as adverse or unexpected outcomes. In this regard, the staff must liaise with the office of the director to make all the necessary efforts to get in touch with the people whose consent is required for a minor with no life-threatening condition.

Court case: A boy aged fourteen was injured when a car in which he was riding with his parents was involved in an accident. When he was taken to the local ED, the doctor examined the damaged and mangled leg with torn nerves and blood vessels. The foot had no circulation (Liang & Moore, 2003). After further assessment, the surgeon decided to amputate the leg without parental consent. The parents sued for lack of parental consent in the amputation. The court held for the parents against the surgeon. It was determined that there was no imminent danger to the child, especially as the child stated that he could still feel and wriggle his toes even after the accident. The doctor was held liable for the damages because he failed to obtain parental consent.

Assignment 2:

Case 1: Notice of Claim Filed Against Phoenix Demands $25 Million after Crash Involving fire Engine Kills Family

The incident involves the killing of a family of three by a Phoenix fire truck. The two adults and a child were in pick-up, which collided with the fire engine at the junction of 29th Avenue and Bethany Home Road (Vandell, 2019). According to the spokesperson for the police department, the fire truck was responding to an emergency when the collision with the pick-up happened. The man died at the scene while the woman and the child, about three months old, were pronounced dead on arrival at the hospital.

The police report also states that three firefighters were taken to the hospital in critical condition. At the time, one of the firefighters had left the hospital while the other two remained for further treatment. The section of the road in which the accident happened remained closed for a few hours as motorists were advised to use alternative routes. According to the police department, investigations were still ongoing.

In a related move, the family sued the Phoenix police department demanding $25 million from the city. The claim emanated from the accident that led to the death of Kenneth Collins aged 20 and Dariana Serrano and their baby, who was three months old. According to the claim which was received by the Arizona state through the public record requests, the firefighters who were involved in the fatal accident were negligent in their driving.

The claim cited the fact that they acted contrary to their department's operating procedure that demanded safe and prudent driving at all times. The complaint also mentioned the fact that the family had not received any report that the fire engine was involved in emergency response and had its lights and siren on. The mother of Serrano was identified as the complainant in the case. She mentioned that the accident caused her immense pain and anguish that would continue for the rest of her life.

Lawsuits against first responders are inappropriate. They should be protected by sovereign immunity, as is the case in many cases. Even when a state allows for legal action against the first responders, it should be in rare situations where there is overwhelming evidence of negligence, malpractice, and action in bad faith.

Legal action against a first responder can only be applicable where a state has put in place the necessary legislation that voids the sovereign immunity against the first-responders. It must be hard to sue a first responder to encourage them to act whenever there are situations of emergency that require their intervention. Otherwise, they would be unwilling to work even in dire circumstances for fear of being sued by the victims.

Because of the presumption that the responders are acting in good faith and guided by the proper conduct, the complainant should be able to prove that they were grossly negligent and acted in bad faith. There has to be a heavy burden on the victim to substantiate these claims. Such stringent measures are necessary to ensure that first responders can help the public in emergencies such as accidents, fires, and others.

In the matter involving the family and Phoenix fire department, the victims were not the intended recipients of the firefighting service. However, they were killed in the course of the service by the firefighters. If it is evident that the firemen were negligent in their driving, then the compensation should be given to the family. They have to prove the negligence of the drivers to get the claim against the Phoenix fire department.

Case 2: Ariz. First Responders named in Wrongful Death Lawsuit

In this case, the family of a man who died due to overheating after a car crash filed for wrongful death. In this case, they claimed that the authorities used excessive force on the deceased and failed to administer the necessary medical intervention leading to death.

According to the lawsuit, the late David Cutler, who was a 23-year-old student, was visiting his brother in Tucson (Schmidt, 2018). As he was driving his car in the desert, the vehicle crashed and caught fire from the resulting oil leak. Mr. Cutler then escaped from the vehicle and ran away from the scene, according to the charges.

A while later, certain first responders, including paramedics and sheriff's deputies were sent to the location, found the vehicle burning and Cutler out of sight. About two hours later, a witness who heard the deceased's cries for help called 911 and Deputy Keith Banes responded to the call. He found Cutler naked, on top of a hill screaming for help. By then, he had been in the desert for over two hours and endured over 100 degrees of heat. The deceased had been there without water or shelter for the entire period.

The lawsuit further claims that Deputy Baines knew the condition of the deceased but still offered him no food or water, but instead approached him with a baton and pepper spray and demanded to handcuff him. Cutler then accepted to be handcuffed without offering any resistance. Instead of calling for paramedics for Cutler, who was then covered in blood, the deputy ordered him to walk down the hill, verbally abused, and slammed him against the ground. The suit further claims that the deputy asked the paramedics to sedate him, claiming that he was resistant and delusional, yet he was already arrested.

The paramedic who is also listed in the suit, without checking Cutler's vital signs, went ahead and sedated him instead of treating him for the heat distress he was suffering. The lawsuit further states that while still in the desert, his breathing slowed, and he became still; the handcuffs were removed, and the paramedic attempted a CPR on him. A variety of other drugs were given to him to try to revive him before he was...