HIPPA is a very big issue with medical boards so I guess it would most likely be up to them if a camera should be mounted in an ambulance or not,cuz you may have a patient that says they used illegal drugs,and they may not even say that knowing that the conversation is being recorded.
Cameras in Ambulances?
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I don't think thats true - I'm pretty sure federal wiretapping regulations are the controlling law here, and they would prohibit any such use of a sound recording.
http://www.law.cornell.edu/uscode/18/usc_sec_18_00002515----000-.html
"Whenever any wire or oral communication has been intercepted, no part of the contents of such communication and no evidence derived therefrom may be received in evidence in any trial, hearing, or other proceeding in or before any court, grand jury, department, officer, agency, regulatory body, legislative committee, or other authority of the United States, a State, or a political subdivision thereof if the disclosure of that information would be in violation of this chapter. "
Note that this only applies to sound recordings however - it hasn't been updated since the advent of videocameras...so video without sound raises no issues (but of course are very unlikely to capture a confession of some sort).
This would also seem to raise a number of confidentiality issues - the doctor/patient privelage is well established, and my understanding is that such a privelage is generally extended to other healthcare providers.
I am unclear as to whether the healthcare provider themselves can choose to testify to any health-related conversations, but am fairly certian they could not be made to testify.
At any rate, it is far less likely that information given to an EMT as said EMT was in the process of administering care would be admissable as evidence than would a confession made to a police officer, excepting any issues with Miranda warnings, etc.
http://www.law.cornell.edu/uscode/18/usc_sec_18_00002515----000-.html
"Whenever any wire or oral communication has been intercepted, no part of the contents of such communication and no evidence derived therefrom may be received in evidence in any trial, hearing, or other proceeding in or before any court, grand jury, department, officer, agency, regulatory body, legislative committee, or other authority of the United States, a State, or a political subdivision thereof if the disclosure of that information would be in violation of this chapter. "
Note that this only applies to sound recordings however - it hasn't been updated since the advent of videocameras...so video without sound raises no issues (but of course are very unlikely to capture a confession of some sort).
This would also seem to raise a number of confidentiality issues - the doctor/patient privelage is well established, and my understanding is that such a privelage is generally extended to other healthcare providers.
I am unclear as to whether the healthcare provider themselves can choose to testify to any health-related conversations, but am fairly certian they could not be made to testify.
At any rate, it is far less likely that information given to an EMT as said EMT was in the process of administering care would be admissable as evidence than would a confession made to a police officer, excepting any issues with Miranda warnings, etc.
Ridryder911
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Couple of things.. wire tapping is an illegal connection of their own private line such as the persons own telephone line. This is not to be confused with videotaping by others by electronic means. Look at store security cameras, police cameras, etc
Don't think they will make you testify against a patient, you are foolish. You as an EMT do not have the same Doctor -patient privacy act. In fact even physicians even have to divulge information if the court amends it so that it would place the patient or even others in danger. That is why even physicians, psychiatrist and psychologist should tell patients upfront that confidentially can only be held up to the point ; if there appears to be endangerment to others or themselves they will have to divulge the information and take action upon it.
Moment it is cleared and I summoned by the court, I will testify with all facts. To not do so would be in-contempt, and perjured if not answering truthfully.
Patient confidentially is where this all this belongs, this is NOT associated with HIPPA or its rulings. HIPPA in fact is not endorsed except to those that do electronic billing.
R/r 911
Don't think they will make you testify against a patient, you are foolish. You as an EMT do not have the same Doctor -patient privacy act. In fact even physicians even have to divulge information if the court amends it so that it would place the patient or even others in danger. That is why even physicians, psychiatrist and psychologist should tell patients upfront that confidentially can only be held up to the point ; if there appears to be endangerment to others or themselves they will have to divulge the information and take action upon it.
Moment it is cleared and I summoned by the court, I will testify with all facts. To not do so would be in-contempt, and perjured if not answering truthfully.
Patient confidentially is where this all this belongs, this is NOT associated with HIPPA or its rulings. HIPPA in fact is not endorsed except to those that do electronic billing.
R/r 911
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That's true in that the when one says "wiretapping" they mean to tap a phone line. But the law that is commonly called the "wiretapping law" (the one I posted above) also prohibits the capture of oral communication, and the use of any such captured information in a courtroom.
I should have been more clear - such cameras are not "wiretaps," but if they capture sound as well as video are subject to the "Federal wiretapping law" and would probably be illegal, and the sound information could not be used in a court of law.
Also true - the wiretapping law does not cover such recordings so long as they do not "intercept" "oral communication." mfrjason made refrence to a recorded conversation though - which would consist of such an interception of oral communication - and is prohibited.
As for the priveledge stuff - you are correct - there are any number of limitations on the doctor-patient priveledge, and in general these seem to be determined by individual states. A quick search turned up no relevant case law in terms of applying such a priveledge to other medical providers such as EMT's, but I stumbled over this:
http://healthvermont.gov/hc/ems/march2001.pdf
which suggests that in VT at least, some limited priveledge does exist.
Massachusetts (home for me) seems to only provide priveledge for psychotherapists - I can't find any law granting any privledge at all to doctors.
In short I should probably not make overreachign generalizations about laws which I haven't taken the time to look up first...:blush:....especially when each of the 50 states are likely to have completely different rules, and federal law may well have something to say as well. Ultimately this does seem to be a very unsetteled area of law for doctors - nevermind other medical providers - I think i just assumed that such priveledge does exists becasue I happen to think it should....
Ridryder911
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No problem .. hypothetical situation. You respond to a patient that has a severe laceration, that he reports that he received it when he "raped and murdered" a female. Would you not report or since the statement was under patient confidentially leave it alone ?
The same as a "dying decree" is very often used in a court of law. It is very confusing and ethical debate.
I agree personal confidentially is very sacred, but there is a fine line and ethical debate on what items should be divulged..
Personally, if it does not regard your care, treatment, and physical finding, I will report it. Such as in child/ adult abuse, violent crimes, spousal abuse.. etc
R/r 911
The same as a "dying decree" is very often used in a court of law. It is very confusing and ethical debate.
I agree personal confidentially is very sacred, but there is a fine line and ethical debate on what items should be divulged..
Personally, if it does not regard your care, treatment, and physical finding, I will report it. Such as in child/ adult abuse, violent crimes, spousal abuse.. etc
R/r 911
firecoins
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I am pretty sure an EMT and Parmedic do in fact fall under the patient-doctor relationship because we are acting under medical control a.k.a the ER doctor. However the privacy law applies to him it is applied to us in that manner.
Ridryder911
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Actually, we fall under patient privacy act but not a physician-privacy, since we are not the actual practitioners rather we are only extenders of their care. The same as nurses on the med-surg floor, ICU, lab tech's etc.. everyone that does not have a license to practice medicine, only operate under the orders of the authorizing physician.
Once the medical chart has been subpoenaed and warranted, one can as well be subpoenaed as well of the discussion and interaction of a patient. Not cooperating can be interpreted as interference and withholding evidence, and if refused could be held as possible contempt of court.
One assumes physicians can refuse to discuss patient-client discussion which is a myth. This is one of the t.v. drama's they love to push but actually, once a court has intervened and has a warrant, the physician is suppose to cooperate with authorities.
Remember there are certain instances that mandated to be reported. Suspected child abuse, violent crimes, communicable diseases etc.. has a mandated reported system, usually falling under the Public Health Law's.
R/r 911
Once the medical chart has been subpoenaed and warranted, one can as well be subpoenaed as well of the discussion and interaction of a patient. Not cooperating can be interpreted as interference and withholding evidence, and if refused could be held as possible contempt of court.
One assumes physicians can refuse to discuss patient-client discussion which is a myth. This is one of the t.v. drama's they love to push but actually, once a court has intervened and has a warrant, the physician is suppose to cooperate with authorities.
Remember there are certain instances that mandated to be reported. Suspected child abuse, violent crimes, communicable diseases etc.. has a mandated reported system, usually falling under the Public Health Law's.
R/r 911
firecoins
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well a subpoena is different. I wouldn't even think a doctor could refuse that.
I would assume an EMT can not give pt info to a cop just because the cop asked. That being said, we work alongside cops who are usually witnesses to everything we do on scene. That pretty much nullifies the privacy from the law anyway while in their presence.
I would assume an EMT can not give pt info to a cop just because the cop asked. That being said, we work alongside cops who are usually witnesses to everything we do on scene. That pretty much nullifies the privacy from the law anyway while in their presence.
Something like that I would have no qualms about reporting (and would have serious qualms about not reporting.
The information I would be concerned with is exclusively health information - priveledge ought to encourage people to be honest with thier health care provider. Thus I would (as an EMT, a nurse, or a doctor) have a problem with testifying as to a sub-21 someone's state of intoxication or that they told me they had "x number of drinks" ...or had been smoking weed before thier asthma attack - thats information related directly to the treatment of the patient. Rape and murder don't count.
And yep - once the supeona comes in, unless you fight it and win, you're testifying. One would hope, however, that such subpeonas are not given lightly.
Firecoins point does very much interest me. I agree that legally the priveledge would probably be held to be nullified by the presence of the third person, removing an expectation of privacy. I have two problems with this, however.
1. Normally the presence of a third person would nullify any privelege. But if said police officer is a first responder, and responds to a medicall 911 call with the purpose of providing very basic medical care/evaluation - I would consider them ethically (if not legally) no different from responding EMT's (who are, in turn, little or no different than a MD) - they are, at that moment, the health care provider in charge of the care of that patient - and as such I would place the same burden on them to protect patient confidentiality as I would an EMT or a doctor.
Also, the patient has no way to avoid speaking to the EMT (or the doctor, if, perchance, a doctor responds) in the presence of the police oficer. It seems to me to be a bad policy to systematically deny the possibility of confidental medical care by sending a police officer to every call. Could an officer similalrly enter an exam room in a hospital and nullify the doctor-patient priveledge there? How about the confessional of a church?
To me the end result is the same: to make patients that much more reluctant to be truthful to their care providers.
Ridryder911
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I document such statements as admission of alcohol, substance abuse and amount, use or lack of use of restraints in vehicle, etc. I ask (as I should)they report, I document it. This is part of the medical history this could be used as a differential diagnoses on altered LOC or other related medical problems, the same as glucose level, neuro exam's, etc.
If they are stupid enough to perform such behavior, then one has to be responsible enough to suffer the consequences of such behavior.
I do take patient confidentially serious, but I am not their priest or do I have a legal binding contract of physician (practitioner) privacy, (as a NP I will have one as a practitioner) but as an EMT or medic only the patient confidentiality laws pertaining such.
R/r 911
If they are stupid enough to perform such behavior, then one has to be responsible enough to suffer the consequences of such behavior.
I do take patient confidentially serious, but I am not their priest or do I have a legal binding contract of physician (practitioner) privacy, (as a NP I will have one as a practitioner) but as an EMT or medic only the patient confidentiality laws pertaining such.
R/r 911
Medic's Wife
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My husband works for Rural Metro, and they've just had cameras installed in their ambulances. From what I understand they are activated by irratic driving. I'm not sure if he's made up his mind whether or not he likes them, but it definitely got me thinking when he told me about them.
Stevo
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methinks we'd have a grand time mooning the boss....
~S~
~S~
Airwaygoddess
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To the song of "I SEE A BAD MOON A RISING!":lol:
:lol:Its hard to say if you would report it or not but your insides would be saying do it cuz you know that he hurt someone and should pay for it.
Sounds like they are using them for QA reasons so that they can be used when it comes time for driver training so that way they know what NOT to do.
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Sounds like the "DriveCam" system. They've been used to help, and hurt EMT's... they help prove that the ambulance had a GREEN light when they entered the intersection, but they can also prove that the light was RED and the ambulance failed to stop.
As for dying decrees... if a patient makes a statement in the ambulance admitting to a crime, it will probably end up in my chart as a direct quote, because it is unusual for a patient to do that... and that way, it is on a legal document, too.
As for dying decrees... if a patient makes a statement in the ambulance admitting to a crime, it will probably end up in my chart as a direct quote, because it is unusual for a patient to do that... and that way, it is on a legal document, too.
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A couple of funny DriveCam videos I've seen/heard of from our service:
1. While not driving code, and only repositioning, EMT goes through a red light, nearly hits a loaded school bus (while on his cell phone), and then has the balls to roll down the window and start yelling at the bus. The bus calls PD, PD calls the ambulance service, and the service reviews the tape (the thing was set off when he slammed on his brakes to avoid the school bus). He was fired on the spot.
2. Ambulance hits a loaded school bus while coding. It turns out that the school bus was stopped, the EMTs note this, saying "Right clear... left clear.." and you can see it stopped. Then as they get to the intersection the bus accelerates into the ambulance. Driver says they had a green while everyone else, including other cars, state bus still has red. DriveCam proved they had red, stopped at red, and mysteriously started driving again while it was still red.
3. Crews would drive RIGHT up to a tree, with the bumper just touching it. Then they'd start yelling, screaming, and waving different things in front of the camera. One person would yell "OH :censored::censored::censored::censored:, A TREE" while a third person would thump the outside of the ambulance real hard. It always made us laugh. Not so much the supervisors though
1. While not driving code, and only repositioning, EMT goes through a red light, nearly hits a loaded school bus (while on his cell phone), and then has the balls to roll down the window and start yelling at the bus. The bus calls PD, PD calls the ambulance service, and the service reviews the tape (the thing was set off when he slammed on his brakes to avoid the school bus). He was fired on the spot.
2. Ambulance hits a loaded school bus while coding. It turns out that the school bus was stopped, the EMTs note this, saying "Right clear... left clear.." and you can see it stopped. Then as they get to the intersection the bus accelerates into the ambulance. Driver says they had a green while everyone else, including other cars, state bus still has red. DriveCam proved they had red, stopped at red, and mysteriously started driving again while it was still red.
3. Crews would drive RIGHT up to a tree, with the bumper just touching it. Then they'd start yelling, screaming, and waving different things in front of the camera. One person would yell "OH :censored::censored::censored::censored:, A TREE" while a third person would thump the outside of the ambulance real hard. It always made us laugh. Not so much the supervisors though
fm_emt
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This is not the case in many jurisdictions, and I believe ours is one of them. If you're recording someone with a video camera, and you capture *audio* as well, you're in trouble.
This happened in Florida a few years back. Some guy was secretly videotaping his wife (who was running a brothel) in the act, and he had the microphone on. They ran afoul of Florida's wiretap laws.
Wiretapping can also include emails now. It's a LOT more than "an illegal connection of their own private line" these days.
Thank the "War on Terror" for that.
A couple of funny DriveCam videos I've seen/heard of from our service:
1. While not driving code, and only repositioning, EMT goes through a red light, nearly hits a loaded school bus (while on his cell phone), and then has the balls to roll down the window and start yelling at the bus. The bus calls PD, PD calls the ambulance service, and the service reviews the tape (the thing was set off when he slammed on his brakes to avoid the school bus). He was fired on the spot.
2. Ambulance hits a loaded school bus while coding. It turns out that the school bus was stopped, the EMTs note this, saying "Right clear... left clear.." and you can see it stopped. Then as they get to the intersection the bus accelerates into the ambulance. Driver says they had a green while everyone else, including other cars, state bus still has red. DriveCam proved they had red, stopped at red, and mysteriously started driving again while it was still red.
3. Crews would drive RIGHT up to a tree, with the bumper just touching it. Then they'd start yelling, screaming, and waving different things in front of the camera. One person would yell "OH :censored::censored::censored::censored:, A TREE" while a third person would thump the outside of the ambulance real hard. It always made us laugh. Not so much the supervisors though
He got what he deserved. We are not safe from the fields of litigation,and doing something as stupid as what that driver did,especially to a bus loaded with kids. I guess you can also say the driver of the bus was liable too cuz of the fact that he wasnt paying any attention to traffic.