BLS Legal & Ethical Considerations 3 — Questions and Answers
Question 1: A child suffers cardiac arrest at school. A teacher wants to perform CPR but the parents are unreachable. Which consent principle applies?
- Parental consent must be obtained before any treatment
- Implied consent allows treatment to save the child's life (Correct answer)
- The school principal must authorize the intervention
- CPR should be withheld until legal guardian arrives
Correct answer: Implied consent allows treatment to save the child's life
Implied consent covers minors in life-threatening emergencies when a parent or guardian cannot be reached in time.
Question 2: An off-duty paramedic witnesses a collapse in a restaurant. Legally, their obligation to respond compared to a layperson is generally:
- Identical — no extra duty exists outside their jurisdiction
- Greater — many states impose a duty to act on licensed providers (Correct answer)
- Lesser — they are protected by off-duty immunity statutes
- Nonexistent — they have no legal standing without their equipment
Correct answer: Greater — many states impose a duty to act on licensed providers
Many states hold licensed healthcare professionals to a higher standard and may impose a duty to act even when off duty.
Question 3: Which term describes the legal concept that a competent adult patient must receive enough information to make an informed decision about their care?
- Expressed consent
- Informed consent (Correct answer)
- Implied consent
- Substituted judgment
Correct answer: Informed consent
Informed consent requires providers to explain risks, benefits, and alternatives so the patient can decide voluntarily.
Question 4: A rescuer begins CPR on a victim who then regains consciousness and clearly refuses further assistance. The rescuer should:
- Continue CPR until EMS arrives regardless of the patient's wishes
- Stop CPR and respect the now-competent patient's refusal (Correct answer)
- Restrain the patient to complete the resuscitation cycle
- Call medical control for permission to stop
Correct answer: Stop CPR and respect the now-competent patient's refusal
A conscious, competent adult has the legal right to refuse treatment at any point, including ongoing CPR.
Question 5: In BLS ethics, 'nonmaleficence' most directly means a provider should:
- Always attempt resuscitation regardless of circumstances
- Avoid causing unnecessary harm to the patient (Correct answer)
- Treat all patients equally regardless of background
- Act in the patient's best interest even against their wishes
Correct answer: Avoid causing unnecessary harm to the patient
Nonmaleficence is the obligation to 'first, do no harm' — avoiding actions that cause unnecessary injury or suffering.
Question 6: A patient with a valid out-of-hospital DNR experiences respiratory arrest. Which intervention remains APPROPRIATE?
- Defibrillation with an AED
- Chest compressions
- Comfort measures and emotional support (Correct answer)
- Endotracheal intubation
Correct answer: Comfort measures and emotional support
A DNR does not preclude comfort-oriented care; providers should keep the patient comfortable and support family.
Question 7: Which element is NOT typically required for a Do-Not-Resuscitate order to be legally valid in the United States?
- Patient or surrogate signature
- Physician's signature
- Notarization by a licensed notary (Correct answer)
- Date of execution
Correct answer: Notarization by a licensed notary
Most states require patient/surrogate and physician signatures with a date, but notarization is not a standard requirement for DNRs.
BLS Legal & Ethical Considerations 3
A child suffers cardiac arrest at school.
A teacher wants to perform CPR but the parents are unreachable.
Which consent principle applies?