AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. February 2003, Volume 5, Number 2.


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Glossary: Emergency Medicine

Glossary of terms used in this issue.

February 2003, Volume 5, Number 2

Brain death - irreversible cessation of cerebral and brain stem function; characterized by absence of: electrical activity in the brain, blood flow to the brain, and brain function as determined by clinical assessment of responses. A brain dead person is dead, although his or her cardiopulmonary functioning may be artificially maintained for some time.

Confidentiality – the principle that prohibits physicians from disclosing confidential comments made to them by patients unless required to do so by law. The law may require physicians to violate patient confidentiality if the patient poses a serious threat to his or her own health and the well-being or that of others.

Decisional capacity – ability to make health care decisions in one's own best interest. Decisional capacity can be temporarily compromised by alcohol or chemical intoxication, hypoxia, sedation, stress, and other causes. Those who judge the decisional capacity of others often rank it along a continuum. One may have sufficient decisional capacity to refuse an analgesic or suturing of a laceration but insufficient decisional capacity to refuse life-saving treatment.

Emergency medical condition – according to EMTALA, presence of acute symptoms of such severity that the absence of immediate medical attention could reasonably be expected to result in (1) placing the health of the individual in serious jeopardy, (2) serious impairment to bodily functions, (3) serious dysfunction of any bodily organ or part, or, in the case of a pregnant woman having contractions, (4) inadequate time for safe transfer to another hospital before delivery, or (5) a transfer that poses a threat to to the health or safety of the woman or the unborn child.

EMTALA - the Emergency Medical Treatment and Labor Act – federal legislation enacted in 1986 to assure that all Americans would have access to emergency medical care, regardless of their ability to pay.

Medical screening examination – under EMTALA, an examination to determine whether an emergency condition exists.

Privacy - a patient's right to have present during the clinical encounter only those involved in his or her medical care.

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