Public Health Law Map - Beta 5 - Medical and Public Health Law Site

interfere with getting the child prompt emergency care. The school system should
have a formal policy, and preferably a written contract, for ambulance services for
children who are seriously ill or injured. Schools need not wait for parental
permission to call an ambulance. Paying the ambulance fee is much less expensive
than settling the claim on the broken neck that became a spinal cord injury when
the teacher carried the child into the office.
c) Medicines at School
School health programs should be cautious about inserting themselves between a
physician and a patient or between a parent and a child when providing medical
care for children. It has become common practice to take medicines away from
school children and insist that the child come to the office or the nurse for
treatment. If the school is prepared to take responsibility for administering the
medicine properly and on time and if the teacher or nurse can be sure that the child
leaves with the medicine so that nighttime doses can be given, the school may not
increase its legal risks by doing this. It also does not reduce its risks.
This policy can lead to major problems for the school in two situations. If the
school nurse or physician does not agree with the prescriptions of the attending
physician and prevents the child from following the physician’s orders, then the
school personnel would be liable for any harm that came to the child because of the
lack of medical care. A school nurse or doctor who substituted other medical care
for that prescribed by the attending physician would be liable for rendering care
without legal consent. It is wise to remember that for a physician or a nurse, telling
a patient not to do something is an act of medical judgment.
The other serious problem involves situations when it is medically important that
the patient control his or her own medications. The asthmatic child cannot use
inhalers on demand if the inhalers are in the nurse’s office. The attack that could
have been aborted by the inhaler in the pocket may require emergency care in the
time it takes to find the person with the key to the medicine locker.
If responsibility is a central issue in the patient’s care, then no amount of planning
by the school nurse can make up for the harm done by removing medications.
Adolescents with diabetes are typically very hard to maintain in control. They shift
from denial to dependence very quickly. They must cooperate with their physicians
and their parents and a host of others. If the school officials are not active
participants in this child’s care program, they should not interject themselves into
the care.
d) Athletics
The information elsewhere in this section about being a team doctor applies
whether the physician takes on the team separately or as part of the work of the
school doctor. Physicians who are considering accepting a position as a school
physician should find out whether they are expected to care for athletes. If the
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