BLS Legal & Ethical Considerations 4 — Questions and Answers
Question 1: During a mass casualty event, a BLS provider must choose which patients to treat first with limited resources. This reflects which ethical principle?
- Autonomy
- Nonmaleficence
- Justice (Correct answer)
- Veracity
Correct answer: Justice
Justice requires fair allocation of limited resources, which is the foundation of triage systems in mass casualty events.
Question 2: A 17-year-old minor seeks BLS treatment after a witnessed collapse at a mall. Legally, treatment should be:
- Withheld until a parent or guardian provides consent
- Provided under implied consent due to the life-threatening emergency (Correct answer)
- Delayed until the minor signs a consent form
- Referred only to licensed providers who can obtain parental consent remotely
Correct answer: Provided under implied consent due to the life-threatening emergency
Life-threatening emergencies involving minors are covered by implied consent when a parent is unavailable.
Question 3: A BLS provider at a community event finds a victim unresponsive with no pulse and a prominent tattoo reading 'DNR.' How should the provider respond?
- Honor the tattoo as a valid DNR and withhold CPR
- Begin CPR because a tattoo is not a legally recognized DNR order (Correct answer)
- Call poison control for guidance before acting
- Only apply an AED but skip chest compressions
Correct answer: Begin CPR because a tattoo is not a legally recognized DNR order
Tattoos are not legally recognized DNR documents; without a valid written order, BLS providers should initiate CPR.
Question 4: The principle of 'beneficence' in BLS ethics requires providers to:
- Always follow the patient's stated wishes without exception
- Actively promote the patient's well-being and best interests (Correct answer)
- Avoid any intervention that carries risk of harm
- Treat all patients identically regardless of prognosis
Correct answer: Actively promote the patient's well-being and best interests
Beneficence obligates providers to take positive actions that benefit the patient and promote their welfare.
Question 5: Which statement about advance directives and out-of-hospital cardiac arrest is MOST accurate?
- EMS providers are required to attempt CPR regardless of any advance directive
- Valid advance directives must be honored by EMS if properly presented (Correct answer)
- Advance directives are only enforceable in hospital settings
- An advance directive must be signed the same day as the cardiac arrest to be valid
Correct answer: Valid advance directives must be honored by EMS if properly presented
EMS providers must honor properly executed and presented advance directives, including out-of-hospital DNR orders.
Question 6: A rescuer is concerned about contracting a disease while performing mouth-to-mouth rescue breathing. Ethically, the rescuer should know that:
- Risk to the rescuer outweighs all obligation to provide care
- Barrier devices and chest-compression-only CPR can reduce but not eliminate risk (Correct answer)
- Mouth-to-mouth is legally required regardless of personal risk
- The victim must provide health history before care can begin
Correct answer: Barrier devices and chest-compression-only CPR can reduce but not eliminate risk
Compression-only CPR and barrier devices are reasonable alternatives that reduce infection risk while still providing effective resuscitation.
Question 7: A competent adult refuses CPR after being found pulseless and unresponsive. Which scenario makes refusal legally problematic?
- The patient verbally refused CPR two days earlier
- The patient is currently unconscious and cannot express a current wish (Correct answer)
- The patient's family members disagree with the refusal
- The patient is elderly and in poor baseline health
Correct answer: The patient is currently unconscious and cannot express a current wish
Refusal requires current decisional capacity; an unconscious patient cannot exercise real-time refusal, making implied consent applicable.
BLS Legal & Ethical Considerations 4
During a mass casualty event, a BLS provider must choose which patients to treat first with limited resources.
This reflects which ethical principle?