Legal Learning

Over the past few years in EMS, we’ve heard a lot about “standardizing” EMS across all fifty states in the US, whether it’s the Institute of Medicine’s report or the recently adopted National EMS Education Standards and Instructional Guidelines.   Fair enough.  The proverbial Mrs. Smith’s COPD probably won’t be too different between Peoria, Illinois and Peoria, Arizona.  Oxygen, breathing treatments, and medications work the same across state lines.

From my perspective as an attorney, paramedic, and occasional EMS educator, one thing that shouldn’t be part of a standardized curriculum is the dreaded medical-legal section.  Besides my ongoing pet peeve that medical-legal is the one EMS topic we continue to allow to be taught by the uninformed, we continue to assume that a one-size-fits all approach to medical legal education suffices.  Aside from a few Federal law issues (HIPAA, EMTALA, and CLIA most notably), the overwhelming majority of EMS law, particularly the regulatory framework and tort law, is decided by the individual states.  Other issues, such as advanced directives and medical direction/protocols are equally dependent on state law.

For aspiring medics to be truly informed on their respective legal issues, the best thing that we could do is to take the following steps.  1) Remove the legal curriculum from being part of a national curriculum. 2) Ensure that the legal principles taught in initial EMS education programs are taught by experts and/or developed by the appropriate state regulatory body. 3) Ensure that any testing on EMS legal principles is done at the state level.

But hey, what do I know?  It’s not like I’m a lawyer or anything.


  1. George Kiss says:

    Uh yeah-I’m not “standardizing” anything. I’ll follow evidenc-based guidelines but waiting for things to improve or change on a national basis is just too slow. You realize that EMS JUST became a sub-specialty of emergency medicine. Many agencies are mired in the politics of medicine rather than being patient-focused. Or they’re led by administrators or physicians more concerned about money than EMS. How many agencies in my region alone have medical direction that consists of a signature on old guidelines once a year. Texas has recently taken steps to curb this type of disturbing behavior but it’s sad that it even occurs.

  2. Whew! I wasn’t sure what you were going to post after today 😉

  3. Alfonso R. Ochoa says:

    Medical and nursing education is standardized across the U.S., however candidates for medical/nursing licensure in Texas must pass a jurisprudence examination as per the Texas Medical Board/Texas Board of Nursing. I don’t find it far fetched that the same should apply to EMS candidates. Then again, that pesky certification vs. licensure issue might come up.

    • Education for nurses and doctors is for a structured indoor environment. Temps the same every where humidity standardized. Emergency medicine is in an uncontrolled environment, and standardization nation wide leads to frost bite education requirements in the Florida keys, and alligator injury training in north dakota, unfortunately these two things displace more useful training, or add needless expense.

  4. So. You want us to be educated like professionals? Where’s the push to be rewarded/recognized/compensated like the same? What about the idea that EMS is often the whipping boy of your local emergency medical community. Something went wrong with response? Blame the medics. Bad outcome? Blame the medics. Why not accept as Dr. House, I believe, has said and i roughly paraphrase. Sometimes bad things happen and it’s not anyone’s fault. Rant over.

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