Paramedic Practice: PROP 7.1 & 7.2 Quiz on Law, Ethics, and Consent

This assignment comprises two quizzes, PROP 7.1 and PROP 7.2, designed to assess understanding of legal and ethical principles relevant to paramedic practice. PROP 7.1 is a multiple-choice quiz covering topics such as law, professional misconduct, coroner's court procedures, patient consent, and evidence gathering. PROP 7.2 is a short-answer quiz exploring the differences between criminal and civil law, the legal implications of paramedic registration, the protection of the title 'paramedic,' and the definition of 'unsatisfactory professional performance.' It further delves into issues of confidentiality, including breaches, exceptions, and the distinction between confidentiality and privacy. The quiz also examines patient consent, competence, the 'Doctrine of necessity,' and the rights of patients to refuse treatment. The quizzes provide a comprehensive overview of the legal and ethical responsibilities of paramedics, including their interactions with patients, the legal system, and professional standards.

PROP 7.1 - MULTIPLE CHOICE QUIZ
Question 1 of 10
What is referred as the system of rules and regulations that promotes justice and monitors the
violation of human rights?
Theory
Law
Resolution
Provision
Question 2 of 10
This is known as precedent law, which allows the development of the law:
Common law
Parliamentary law
Fixed law
All of the above
Next
Question 3 of 10
To ensure that the public is protected from harm brought about by health
professionals by regulating competency and practice standards, there is a need for
a:
Registering body

Union
Regulating body
Both first and third option
Next
Question 4 of 10
A level of professional misconduct, which pertains to knowledge and skills issues
identified to be concerning at the level of expected and required functioning as a
competent healthcare professional:
Unprofessional conduct
Unsatisfactory professional performance
Negligence
None of the above
Next
Question 5 of 10
There is a need to go the Coroner’s Court in the following situations, EXCEPT:
Violent death
Unnatural death
Death of a patient under comfort care approach
Unknown cause of death

Question 6 of 10
If you are a nurse anticipating a Coroner’s case for a patient’s death, what should be
your responsibility?
Remove all interventions like IV lines, catheters and others to facilitate easy
investigation.
The body should be left exactly the same as it was at the time of death.
Provide post-mortem care prior to investigation.
Change the patient’s clothes accessible for possible autopsy.
Next
Question 7 of 10
When suspecting a patient, who presents herself in ED, for the possibility of
involvement in a serious crime, what is your priority?
Call the police
Gather evidence
Interview the client’s history of injury
Provide care for the patient
Next
Question 8 of 10
What is the general rule in gathering evidence?
Ask who did this to the child
Ask the parents
Ask the child

Refer to the appropriate agency
Next
Question 10 of 10
What is a valid consent?
A consent obtained without coercion; the patient must be fully informed and must be
competent to give consent.
A consent obtained with full participation of the nurse and relatives.
A consent offered through acceptance of rewards and incentives.
All of the above.
Next
PROP 7.2 - SHORT ANSWER QUIZ
Question 1 of 44
Describe the difference between criminal law and civil law. Provide an example for
each.
The main difference between civil and criminal law deals with people who committed a
wrong against another person. Criminal law, on the other hand, deals with an individual's
offenses against the state or federal government
Civil laws regulate disputes between private parties. This lesson explains the main
differences between criminal and civil law.
Question 2 of 44
Why does the lack of registration for paramedics create legal problems?
The lack of registration of paramedics creates legal problems as these paramedics
perform high risk interventions and does not have any national standard of training
or any code of conduct owing to the absence of proper registration. Moreover, This
would enable the general public from identifying the genuine ones and protect them
from being treated by the fake ones.
Question 3 of 44

The term ‘paramedic’ also creates concerns for patient safety. What would
protection of the title ‘paramedic’ mean for the general public?
The protection of the title paramedic would prevent the knowing or reckless use of
the title. This would enable the general public from identifying the genuine ones and
protect them from being treated by the fake ones. Moreover, the paramedics would
be recognised properly.
Question 4 of 44
What is meant by the term ‘unsatisfactory professional performance’?
Unsatisfactory professional performance means a level of professional misconduct,
which pertains to knowledge and skills issues identified to be concerning at the level
of expected and required functioning as a competent healthcare professional.
Question 5 of 44
Can a paramedic be charged with ‘professional misconduct’? Why/ Why not?
Yes a paramedic can be charged with professional misconduct so that the
paramedics are not indulged into reckless and negligent activities. The paramedics
are required to conduct their duties responsibly.
Question 6 of 44
If a paramedic was seen to have failed to provide the care, or worked outside of their
scope of clinical practice (unauthorised), what action may be taken against the
paramedic?
If a paramedic was seen to have failed to provide the care, or worked outside of their
scope of clinical practice, the aggrieved person can bring a court action against the
paramedic under the Civil Liability Act. the complaint can be brought to the relevant
state or territory complaint authority.
Question 7 of 44
How could your position as a paramedic be involved in the Coroner’s court?
When a body is required to be investigated in the coroner’s court, the paramedic is
required to prepare the body for examination by the coroner’s court. Moreover, if
required the paramedic is also required to appear in the coroner’s court, the
paramedic needs to act accordingly.
CONFIDENTIALITY & PRIVACY:
Question 8 of 44

If you are required to attend court in regards to case you attended, are you able to
provide confidential patient information?
The paramedics are allowed to provide confidential patient information, when they
are required to assist the court or police for the investigation of a crime.
Question 9 of 44
Reading the case (Jackson v Lithgow City Council) provided under ‘Paramedics: pre-
hospital trauma teams and evidence’ what point does this case make?
In this case “Mr Jackson started from his house in Lithgow at around 3.30am, taking with
him his two dogs. He was found at the bottom of a drain at about 6.57am, with multiple,
serious injuries. An ambulance was called. The paramedic’s case notes recorded a history of
“? Fall from 1.5 metres onto concrete”. According to French CJ, Heydon and Bell JJ “He
then decided that in view of the (unproved) expense involved in calling the ambulance
officers and the (unproved) unlikelihood that they could remember anything useful, “it was
not unreasonable” to admit the impugned representation”. However in the opinion of the
Court of Appeal Basten J, “I n my view the cost of obtaining evidence from the ambulance
officers, bearing in mind the size of the claim, the limited likelihood of the officers having
any independent or refreshed recollection of detail which would assist the Court, combine to
demonstrate that, in a practical sense, it was not unreasonable to rely upon the
contemporaneous document.” This case makes the point that accurate recording of the
notes of events and findings from the case by the medical professionals are
important in the investigation of a case in future.
Question 10 of 44
In regards to reporting of offences against children, are paramedics mandated to
report suspected child abuse or neglect?
The paramedics are mandated to report suspected child abuse or neglect and a
failure in doing the same is an offence.
Question 11 of 44
What would constitute as a breach of confidentiality?
The breach of confidentiality implies a disclosure of any records related to the
healthcare of a person without availing his permission. These information are
disclosed by the patients to these healthcare professionals with an implied condition
of non-disclosure. These disclosure can be effected either verbally, in a written form
or any other form.
Question 12 of 44
What could a breach of confidentiality lead to for a paramedic?
The breach of confidentiality by a paramedic is a breach of common law duty. This
gives the aggrieved party a right to prosecute the paramedic and also claim
damages from him. Such a breach may also attract disciplinary charge.
Question 13 of 44
There are situations where exceptions are made for breaches of confidentiality, what
are they?
The situations where exceptions are made for breaches of confidentiality are when
the patient agrees to it, in case of child abuse, while reporting infectious diseases
and while assisting the court or the police in investigating a crime.

Question 14 of 44
What is the difference between confidentiality, and privacy?
Confidentiality implies a condition of non-disclosure of the personal information
provided by the patient in availing treatment. On the other hand, privacy is the
handling of the personal information provided by the patient during the treatment
and afterwards ensuring the protection of the same from being leaked.
Question 15 of 44
How does ‘privacy’ come to play part of your work as a paramedic?
A paramedic is required to maintain the health information of the patients in a fair
and responsible manner in order maintain the privacy of the information and to
protect those information.
CONSENT & CAPACITY:
Question 16 of 44
What are the elements of a valid consent for treatment?
The elements of a valid consent for treatment are it must be free from coercion, the
person giving the consent must be informed about the treatment they are provided
with and the patient must have the competence to consent for the treatment.
Question 17 of 44
Describe ‘competence’
Competence indicates the capability of the patient to give consent to the treatment
or refuse to treatment. A person over the age of 18 years is regarded as competent
to consent. The paramedic would assess whether a patient has the decision-making
capacity for a matter by following three steps, whether the patient can take in, hold
and understand the information of the treatment.
Question 18 of 44
A person is presumed to have capacity to make decisions regarding health care.
How would a paramedic assess whether a patient has the decision-making capacity
for a matter?
The paramedic would assess whether a patient has the decision-making capacity for
a matter by following three steps, whether the patient can take in, hold and
understand the information of the treatment.
Question 19 of 44
Describe the ways in which a paramedic may be charged with assault.
The paramedic may be charged with assault by prosecution and by claiming of
damages. They may also be subjected to disciplinary actions in such a case.
Question 20 of 44
What is meant by the ‘Doctrine of necessity’?
Doctrine of necessity is a situation of life and death where the patient is unable to
give consent owing to unconsciousness or absence of a guardian and the paramedic
is required to treat the person without any consent. This does not incur the liability
to the paramedic.

Question 21 of 44
Do patients have the right to refuse treatment from a paramedic? Explain.
Under the common law, the patients have the right to refuse treatment from a
paramedic. It is the right of the patient to either consent to the treatment from a
paramedic or refuse it.
Question 22 of 44
What is a ‘material risk’?
Material risk indicates the risk that a reasonable person placed in the place of the
patient would identify as a risk or the paramedic is identifying as a risk pertaining to
a particular treatment.
Question 23 of 44
You need to gain IV access to a patient due to his low blood pressure, what will you
advise the patient?
I will advise him to observe a treatment for the low blood pressure.
Question 24 of 44
If he refuses stating he can’t take needles, what do you do?
I would be required to stop the treatment as by saying this the patient has refused to
consent to the treatment.
Question 25 of 44
If he rolls up his sleeve and provides his arm to you – what do you do, why?
If he rolls up his sleeve and provides his arm to you, I will give him the treatment
because this will signify the consent of the patient to the treatment.
Question 26 of 44
When is consent required for children?
Children under the age of 18 years are not competent to consent for their treatment.
The consent needs to be given by the guardian, even the refusal of the treatment is
also required to be given by the guardian.
Question 27 of 44
State the legislation that provides the terms for consent for children in New South
Wales
The legislation that provides the terms for consent for children in New South Wales is
Children and Young Persons (Care and Protection) Act 1998.
Question 28 of 44
Research the corresponding legislation in your State, if you are in NSW, please
provide a search for another State legislation.
The another legislation is Guardianship Act 1987
Question 29 of 44
Can a child under the age of 18 refuse consent for life-sustaining treatment?

No, a child under the age of 18 cannot refuse to consent for life-sustaining
treatment. Irrespective of his consent, the paramedic needs to continue the
treatment.
Question 30 of 44
What is Gillick competency?
Gillick competency indicates whether the child under the age of 16years has the
capacity to consent to treatment or he requires parental permission for the same.
This is an important term in medical science and it has evolved in the United
Kingdom.
Question 31 of 44
When is consent NOT required?
Consent is not required in case of treatment of life-sustaining treatment.
Question 32 of 44
Who may give consent when the patient cannot?
The guardian of the patient can give consent when the patient cannot.
Question 33 of 44
Following the relevant Guardianship Acts in each State (except NT and ACT) – what is
the hierarchy of ‘persons responsible’?
Following the relevant Guardianship Acts in each State (except NT and ACT), the
hierarchy of ‘persons responsible’ are firstly the person’s guardian, secondly the
spouse of the person, thirdly the person who is in charge of care and fourthly a close
relative or friend.
Question 34 of 44
What is an Advanced Care Directive
Advanced Care Directive implies a legal document that a person makes specifying
the actions or the treatment, which they are required to be provided when they will
be unable to consent for themselves owing to their illness.
Question 35 of 44
If there is any doubt of a valid ACD being in place, what should you do for a patient
who requires resuscitation?
If there is any doubt of a valid ACD being in place, a patient who requires
resuscitation needs to be given the same even without the consent.
Question 36 of 44
In regards to the treatment of mentally ill patients, when may a person be detained?
A person having mental illness can be detained when he satisfies the requirements
of having mental illness and he needs to be given a treatment to which he cannot
consent to.
Question 37 of 44
Restraint has become a great issue with increased assaults and violence against
health care professionals. What levels of restraint may be used by a paramedic in
caring for a patient?

The paramedics can restraint a person who is posing threat to themselves or others.
However, the restraint need to be minimum and is only for the purpose of preventing
the patient from harming himself or others.
NEGLIGENCE:
Question 38 of 44
Detail the four elements that contribute to an act of negligence.
The four elements of negligence are a duty of care that the paramedic owes to the patient, that
duty has been breached by the paramedic, a damage has been caused by virtue of that breach
and the damage has a direct relation to the breach. The same can be illustrated with the case
of Donoghue v Stevenson [1932] UKHL 100.According to Boehm (2003), ‘Most jurisdictions
say that there are four elements to a negligence action:
duty: the defendant has a duty to others, including the plaintiff, to exercise reasonable care,
breach: the defendant breaches that duty through an act or culpable omission,
damages: as a result of that act or omission, the plaintiff suffers an injury, and
causation: the injury to the plaintiff is a reasonably foreseeable consequence of the defendant's act
or omission.’
Question 39 of 44
What is a ‘duty of care’ and when is it owed by a paramedic?
The paramedic is incurred with the duty of care while treating a patient and this duty
of care is owed whenever a health practitioner and patient relationship is created.
Question 40 of 44
Do paramedics have a duty of care to patients when they are off duty?
Yes, the paramedics have a duty of care to patients when they are off duty.
Question 41 of 44

How would a ‘breach of duty’ be proved in a paramedic treatment case?
The person who has brought a proceeding against the paramedic for a breach of
duty is required to introduce evidence proving the same.
Question 42 of 44
If you are treating a patient with a drug that you know ‘may’ drop your patient’s
blood pressure, and your patient falls to the floor due to this drop is blood pressure
(stated in drug therapy protocol) causing a head injury to the patient. Would this
be reasonably foreseeable?
Yes, this was reasonably foreseeable as the paramedic knew that the drug ‘may’
drop your patient’s blood pressure and he should have taken precautions for the
same.
Question 43 of 44
What is ‘vicarious liability’? And how does it relate to paramedic practice?
Vicarious liability is a situation where a person being the superior is held liable
legally for the acts or omissions of the other being the inferior. In the paramedic
practice, the employer being the State Health Department is responsible for the
actions of the paramedic.
Question 44 of 44
Could the Ambulance Service be held accountable for the actions of a paramedic if
they followed their protocols in treatment, but through medical consultation provided
a patient with a higher level of medication, resulting in the death (damage) to a
patient?
Yes, in this case the Ambulance Service be held accountable for the actions of a
paramedic, as they are in a position to control the actions of the paramedic.
PROP 7.3 - CASE STUDY QUIZ
Case Study #1
You are working a night shift in the middle of winter when you are called to attend a 67-
yeart-old fitting patient at a rural property. After an extensive drive, you arrive on scene to
be advised the patient has fitted a few times over the past 24hrs, and is currently in a post-fit
state. The owner of the residence is the daughter of the patient, who provides you with
further details about the patient’s condition. The patient has an inoperable brain tumour and is
required to travel to the major hospital facility whenever changes are noted in her condition.
This has increasingly become more and more regular over the past 3 months. The trip takes 2
hours by road, which requires a minimum overnight stay, to then return home within the
following days. The patient was due to take this trip earlier in the day but had refused the
patient transport service who attended, as she wished to stay at home with her family and see
her time out with them rather than in a hospital with strangers.
Question 1 of 4

What are the legal issues that arise with respect to consent?
In this case, the patient has refused to consent for the treatment, which would not be valid as
the person was having fits, which is impairing his ability to consent. Moreover, his daughter
was his guardian for this purpose and has the power to consent for the same. As he is
suffering from a life sustaining disease, the consent would not be required.
Question 2 of 4
What are the legal obligations of the care team when it comes to upholding the
patient's decision or not?
The care team should not uphold the patient's decision as the person was having
fits, which is impairing his ability to consent and he is suffering from a life sustaining
disease, the consent would not be required.
Question 3 of 4
Is there the potential for assault to be committed? If so, how?
No, there are no potential for assault to be committed as the patient has been
suffering for a life threatening disease.
Question 4 of 4
What is the final outcome? Does the patient remain at home? Why or why not?