Expressed consent: a competent adult agrees, verbally or by action, after being informed.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A 16-year-old who is legally emancipated wants to refuse transport after a minor injury. You should treat his decision as:
Answer: A. An emancipated minor has the legal standing of an adult for health care decisions, so consent and refusal follow the adult rules, including a full capacity assessment and informed-refusal discussion. Requiring a parent's confirmation treats him as an ordinary minor, which is the error emancipation removes.
Question 2 of 5
A patient with full capacity declines a treatment you are convinced would help. The ethical principle that settles this is:
Answer: A. Autonomy gives a patient with capacity the final word even when the choice is one you would never make, and that is what separates care from coercion. Beneficence describes your intention and is genuinely in tension here, but it does not override a decision the patient is competent to make.
Question 3 of 5
A study enrolls patients in cardiac arrest, who cannot consent for themselves. Research of that kind is permitted only when:
Answer: A. Research on patients who cannot consent proceeds under a narrow exception that requires prior review and public consultation, so the community that may be enrolled has its say before anyone is. A relative's signature afterward cannot authorize an enrollment that has already happened, and crew enthusiasm is not an ethical safeguard.
Question 4 of 5
At a multiple-casualty incident the ethical framework shifts from doing everything for one patient toward:
Answer: A. When need exceeds resources the obligation runs to the whole group, and that is what justifies spending little time on a patient who would otherwise receive a great deal of it. Order of discovery and equal time both feel fair and both spend scarce minutes where they change the fewest outcomes.
Question 5 of 5
What is the main reason an AEMT uses a length-based resuscitation tape for a child rather than asking the parent for the weight during an emergency?
Answer: A. A length-based tape turns the child's length into an estimated weight and a color zone, which is fast and avoids memory errors under stress. A parent's recent, confident weight may be just as good, so the tape is not always more accurate, and it is a clinical aid rather than a legal requirement. Its value is speed and reliability when the weight is uncertain.
Keep the streak going with more questions like these, each with a full rationale.
What is legal & ethical issues?
A competent adult may refuse care; a patient who lacks capacity is treated under implied consent; and every provider works within the scope of practice for their certification level.
Key points to remember
- Expressed consent: a competent adult agrees, verbally or by action, after being informed.
- Implied consent: an unresponsive or incapacitated patient is assumed to want emergency care.
- A competent adult may refuse — inform them of the risks, encourage care, and document thoroughly.
- Negligence needs four elements: duty, breach of duty, damages, and causation.
- Protect privacy: share patient information only with those involved in the patient's care.
Field priorities
- Assess decision-making capacity before accepting a refusal.
- A valid DNR or advance directive is honored; when validity is in doubt, begin resuscitation.
- Preserve evidence at a crime scene without delaying patient care.
Coaching the patient
- Minors generally need a parent or guardian's consent, but emergency care is not withheld when no guardian can be reached — implied consent applies.
Red flags: act now
- Refusal from a patient with altered mental status, hypoxia or low blood sugar
- Treating a competent adult against their will (possible assault or battery)
- Performing a skill outside your certification level
Legal & Ethical Issues: FAQs
What are the priority actions for Legal & Ethical Issues in the field?
Assess decision-making capacity before accepting a refusal. A valid DNR or advance directive is honored; when validity is in doubt, begin resuscitation. Preserve evidence at a crime scene without delaying patient care.
What findings in Legal & Ethical Issues change your plan or your transport decision?
Refusal from a patient with altered mental status, hypoxia or low blood sugar. Treating a competent adult against their will (possible assault or battery). Performing a skill outside your certification level.
What do I need to know about Legal & Ethical Issues for the NREMT?
Expressed consent: a competent adult agrees, verbally or by action, after being informed. Implied consent: an unresponsive or incapacitated patient is assumed to want emergency care. A competent adult may refuse — inform them of the risks, encourage care, and document thoroughly. Negligence needs four elements: duty, breach of duty, damages, and causation.
What should the crew communicate or document for Legal & Ethical Issues?
Minors generally need a parent or guardian's consent, but emergency care is not withheld when no guardian can be reached — implied consent applies.
