All EMS providers must be familiar with various Massachusetts laws or statutes that are related to or affect Emergency Medical Service operations. The enclosed information provides the minimum information concerning EMS related issues. Additional information may be found within the Massachusetts General Laws.
In addition to laws, there are two sets of regulations promulgated under the authority of the EMS law, EMS (105 CMR 170.000) and First Responder (105 CMR 171.000) regulations.
I. VEHICLE OPERATION
a. Chapter 89, Section 7 EMERGENCY VEHICLE RIGHT OF WAY
The members and apparatus of a fire department while going to a fire or responding to an alarm, police patrol vehicles and ambulances and ambulances on a call for the purposes of hospitalizing a sick or injured person shall have the right of way through any street, way, lane, or alley. Whoever willfully obstructs or retards the passage of any of the foregoing in the exercise of such right shall be punished by a fine of not more than fifty dollars or imprisonment for not more than three months.
b. Chapter 89, Section 7A YIELD TO APPROACHING EMERGENCY VEHICLES
Upon the approach of any fire apparatus, police vehicle, ambulance, or disaster vehicle which is going to a fire or responding to call, alarm or emergency situation, every person driving a vehicle on a way shall immediately drive said vehicle as far as possible toward the right-hand curb or side of said way and shall keep the same at a standstill until such fire apparatus, police vehicle, ambulance or disaster vehicle has passed. No person shall drive a vehicle over a hose of a fire department without the consent of a member of such department. No person shall drive a vehicle within three hundred feet of any fire apparatus going to a fire or responding to an alarm, nor drive said vehicle, or park or leave the same unattended, within eight hundred feet of a fire or within the fire lines established by the fire department, or upon or beside any traveled way, whether public or private, leading to the scene of a fire, in such a manner as to obstruct the approach to the fire of any fire apparatus or any ambulance, safety or police vehicle, or of any vehicle bearing an official fire or police department designation. No person shall operate a motor vehicle behind any such fire apparatus, ambulance, safety or police vehicle, or any vehicle bearing an official fire or police designation which is operating with emergency systems on, for a distance of three hundred feet. Violation of any provision of this section shall be punished by a fine of not more than one hundred dollars. (Amended June 6, 1989)
c. Chapter 89, Section 7B EMERGENCY VEHICLE SPEED & STOP SIGN/LIGHTS
The driver of a vehicle of a fire, police or recognized protective department and the driver of an ambulance shall be subject to the provisions of any statute, rule, regulation, ordinance or by-law relating to the operation or parking of vehicles, except that a driver of a fire apparatus while going to a fire or responding to an alarm, or the driver of a vehicle of a police or recognized protective department or the driver of an ambulance, in an emergency and while in performance of a public duty or while transporting a sick or injured person to a hospital or other destination where professional medical services are available, may drive such vehicle at a speed in excess of the applicable speed limit if he exercises caution and due regard under the circumstances for the safety of persons and property, and may drive such vehicle through an intersection of ways contrary to any traffic signs or signals regulating traffic at such intersection if he first brings such vehicle to a full stop and then proceeds with caution and due regard for the safety of persons and property, unless otherwise directed by a police officer regulating traffic at such intersection. The driver of any such approaching emergency vehicle shall comply with the provisions of section fourteen of chapter ninety when approaching a school bus which has stopped to allow passengers to alight or board from the same, and whose red lights are flashing. (underline added)
d. Chapter 90, Section 7E ; EMERGENCY WARNING LIGHTS (excerpts)
No motor vehicle....other than fire apparatus, ambulances, school buses, vehicles specified in section 7D...and vehicles specified in section 7I shall mount or display a flashing, rotating or oscillating red light in any direction, except as herein provided; provided, however, that nothing in this section shall prohibit an official police vehicle from displaying a flashing, rotating or oscillating red light in the opposite direction in which the vehicle is proceeding or prohibit fire apparatus from displaying a flashing, rotating or oscillating blue light in the opposite direction in which the vehicle is proceeding.
A vehicle owned and operated by a....chief or deputy chief of a municipal fire department, a chaplain of a municipal fire department, a member of a fire department of a town or a call member of a fire department or a member or a call member of an emergency medical service may have mounted thereon flashing, rotating or oscillating red lights. Such lights shall only be displayed when such owner or operator is proceeding to a fire or in response to an alarm and when the official duty of such owner or operator requires him to proceed to said fire or to respond to said alarm, and at no other time.
No such red light shall be mounted or displayed on such vehicle until proper application has been made to the registrar by the head of the fire department and a written permit has been issued and delivered to the owner and operator.
e. Chapter 90, Section 7E; EMERGENCY WARNING LIGHTS (excerpts)
Any person operating a vehicle upon which flashing, rotating or oscillating red lights herein authorized are mounted shall have the permit for said lights upon his person or in the vehicle in some easily accessible place.....
... Nothing in this section shall authorize any owner or operator to disregard or violate any statute, ordinance, by-law, rule or regulation regarding motor vehicles or their use on ways of the commonwealth..... (underline added)
Any person who violates any provision of this section for which a penalty is not otherwise provided shall be subject to a fine of not less than one hundred dollars, nor more than three hundred dollars.
f. Chapter 90, Section 13 (excerpt) CHOCK VEHICLES
Whenever...a truck weighing, unloaded, more than four thousand pounds...shall be parked on a way, on a grade sufficient to cause such vehicle to move of its own momentum, and is left unattended by the operator, one pair of adequate wheel safety chock blocks shall be securely placed against the rear wheels of such vehicle so as to prevent movement thereof.
g. Chapter 90, Section 14 (excerpt) STOP FOR SCHOOL BUS
When approaching a vehicle which displays a sign bearing the words "SCHOOL BUS" and which is equipped with front and rear alternating flashing red signal lamps which are flashing as provided in section 7B, and which has been stopped to allow pupils to alight from or board the same, a person operating a motor vehicle shall, except when approaching from the opposite direction on a divided highway, bring his vehicle to a full stop not less than fifteen feet from said school bus and shall not thereafter proceed until the warning signals are deactivated, unless directed to the contrary by a police officer duly authorized to control the movement of traffic. Any person who violates the provisions of the preceding sentence shall be punished by a fine of not more than one hundred dollars.
NOTE: This excerpt from the school bus law is included so that EMT students can be reminded that ambulances are subject to its provisions even when they are responding to an emergency.
h. Chapter 90, Section 16 (excerpt) USE OF SIREN
No siren shall be mounted upon any motor vehicle except fire apparatus, ambulances, vehicles used in official line of duty by any member of the police or fire fighting forces of the commonwealth or any agency or political subdivision thereof, and vehicles owned by call firefighters or by persons with police powers and operated in official line of duty, unless authorized by the registrar. No person shall use on or in connection with any motor vehicle a spot light, so called, the rays from which shine no more than two feet above the road at a distance of thirty feet from the vehicle, except that such a spot light may be used for the purpose of reading signs, and as an auxiliary light in cases of necessity when the other lights required by law fail to operate.
i. Chapter 90, Section 17 SPEED LIMITS
No person operating a motor vehicle on any way shall run it at a rate of speed greater than is reasonable and proper, having regard to traffic and the use of the way and the safety of the public. Unless a way is otherwise posted in accordance with the provisions of section eighteen, it shall be prima facie evidence of a rate of speed greater than is reasonable and proper as aforesaid (1) if a motor vehicle is operated on a divided highway outside a thickly settled or business district at a rate of speed exceeding fifty miles per hour for a distance of a quarter of a mile, or (2) on any other way outside a thickly settled or business district at a rate of speed exceeding forty miles per hour for a distance of a quarter of a mile, or (3) inside a thickly settled or business district at a rate of speed exceeding thirty miles per hour for a distance of one eighth of a mile, or (4) within a school zone established in conformance with the standards of the department of public works at a rate of speed exceeding twenty miles per hour.
If a speed limit has been duly established upon any way, in accordance with the provisions of said section, operation of a motor vehicle at a rate of speeding excess of such limit shall be prima facie evidence that such speed is greater than is reasonable and proper; but, notwithstanding such establishment of a speed limit, every person operating a motor vehicle shall decrease the speed of the same when a special hazard exists with respect to pedestrians or other traffic, or by reason of weather or highway conditions. No person shall operate a school bus at a rate of speed exceeding forty miles per hour, while actually engaged in carrying school children.
II. LIABILITY
a. Chapter 111C, Section 14 (of EMS law)
No emergency medical technician certified under the provisions of this chapter and no police officer or firefighter, who in the performance of his duties and in good faith renders emergency first aid or transportation to an injured person or to a person incapacitated by illness shall be personally in any way liable as a result of rendering such aid or as a result of transporting such person to a hospital or other safe place, nor shall he be made liable to a hospital for its expenses, if under emergency conditions, he causes the admission of such person to said hospital.
b. Chapter 112, Section 12V (CPR rendered by any citizen)
Any person who is currently certified by the American National Red Cross or the American Heart Association in cardiopulmonary resuscitation, or any person who has successfully met the training requirements of a course in basic emergency care of the unwitnessed cardiac arrest, conducted according to the standards established by the American Heart Association, who in good faith and without compensation renders emergency cardiopulmonary resuscitation in accordance with his training, other than in the course of his regular professional or business activity, to any person who apparently requires cardiopulmonary resuscitation, shall not be liable for acts or omissions, other than gross negligence or willful or wanton misconduct, resulting from the rendering of such emergency cardiopulmonary resuscitation.
III. COMMITTAL OR RESTRAINT OF PATIENTS
a. Chapter 123, Section 12 EMERGENCY RESTRAINT OF DANGEROUS PERSONS; ... (excerpts)
(a) Any physician who is licensed...after examining a person has reason to believe that failure to hospitalize such person would create a likelihood of serious harm by reason of mental illness may restrain or authorize the restraint of such person and apply for the hospitalization of such person for a ten day period at a public facility or at a private facility authorized for such purposes by the department.
...In an emergency situation if a physician or qualified psychologist is not available, a police officer, who believes that failure to hospitalize a person would create a likelihood of serious harm by reason of mental illness may restrain such person and apply for the hospitalization...
...An application for hospitalization shall state the reasons for the restraint of such person and any other relevant information
...Whenever practicable, prior to transporting such person, the applicant shall telephone or otherwise communicate with a facility to describe the circumstances and known clinical history and to determine whether the facility is the proper facility to receive such person and also to give notice of any restraint to be used and to determine whether such restraint is necessary.
b. Chapter 123, Section 21 TRANSPORTATION OF MENTALLY ILL PERSONS; RESTRAINT (excerpts)
Any person who transports a mentally ill person to or from a facility for any purpose authorized under this chapter shall not use any restraint which is unnecessary for the safety of the person being transported or other persons likely to come in contact with him.
In the case of persons being hospitalized under the provisions of section 6, the applicant* shall authorize practicable and safe means of transport, including where appropriate, departmental** or police transport.
Restraint of a mentally ill patient may only be used in cases of emergency, such as the occurrence of, or serious threat of, extreme violence, personal injury or attempted suicide; provided, however, that written authorization for such restraint is given by the superintendent or director of the facility or by a physician designated by him for this purpose who is present at the time of the emergency or if the ... superintendent or director or designated physician is not present at the time of the emergency, non-chemical means of restraint may be used for a period of one hour provided that within one hour the person in restraint shall be examined by the superintendent, director or designated physician.
...Any minor child placed in restraint shall be examined within 15 minutes of the order for restraint by a physician or, ... by a registered nurse or a certified physician's assistant, ...
* ("applicant" refers to the authority, physician etc., who committed the patient)
** ("departmental" refers to Department of Mental Health)
No person shall be kept in restraint without a person in attendance specially trained to understand, assist and afford therapy to the person in restraint.
... in emergency situations, when a person specially trained is not available, an adult, may be kept in restraint unattended for a period not to exceed two hours. In that event, the person kept in restraints must be observed at least every five minutes, provided, further, that the superintendent, director or designated physician shall attach to the restraint form a written report as to why the specially trained attendant was not available.
...No "P.R.N." or "as required" authorization of restraint may be written.
...No later than 24 hours after the period of restraint, a copy of the restraint form shall be delivered to the person who was in restraint.
...A copy of the restraint form and any such attachments shall become part of the chart of the patient.
c. Chapter 123, Section 22 CIVIL LIABILITY
Physicians, qualified psychologists and police officers shall be immune from civil suits for damages for restraining, transporting, applying for the admission of or admitting any person to a facility or the Bridgewater State Hospital, providing said physician, qualified psychologist or police officer acts pursuant to the provisions of this chapter.
IV. OTHER LAWS AFFECTING EMS
a. Chapter 111C, Section 12 CRIMINAL PROHIBITIONS (from EMS law)
No person shall: (1) establish or maintain an ambulance service without a valid license or in violation of the terms of a valid license; (2) operate, maintain, or otherwise use any aircraft, boat, motor vehicle, or other means of transportation as an ambulance without a valid certificate of inspection; (3) operate an ambulance or to serve as an attendant thereon or impersonate, hold oneself out as, or use the title of emergency medical technician or the acronym, EMT in violation of section-six; (4) obstruct, bar, or otherwise interfere with an inspection undertaken under authority of this chapter; (5) knowingly to make an omission of a material fact or a false statement in any application or other document filed with the department; or (6) violate or fail to observe any requirement of this chapter, or of any rule, regulation or order under this chapter, which the requirement the department has made subject to this section by regulation.
Whoever engages in, aids, abets, causes, or permits any act prohibited under the section shall be punished by a fine of not less than one hundred dollars and not more than five hundred dollars for each offense. A separate and distinct offense shall be deemed to have been committed on each day during which any prohibited act continues after written notice by the department to the offender. The commissioner shall report each suspected offense to the attorney general for investigation and, if appropriate, prosecution in the courts of the commonwealth.
b. Chapter 119, Section 51A CHILD ABUSE/NEGLECT MANDATED REPORTER
Any physician, medical intern, hospital personnel engaged in the examination, care or treatment of persons, medical examiner, psychologist, emergency medical technician, dentist, nurse, chiropractor, podiatrist, osteopath, public or private school teacher, educational administrator, guidance or family counselor, day care worker, probation officer, social worker, foster parent, firefighter or policeman who, in his professional capacity shall have reasonable cause to believe that a child under the age of eighteen years is suffering serious physical or emotional injury resulting from abuse inflicted upon him including sexual abuse, or from neglect, including malnutrition, or who is determined to be physically dependent upon an addictive drug at birth, shall immediately report such condition to the department* by oral communication and by making a written report within forty-eight hours after such oral communication;...
...Any such person so required to make such oral and written reports who fails to do so shall be punished by a fine of not more than one thousand dollars. (underline added)
* department = Department of Social Services, see white pages, or blue pages in Boston area directory, under MASS. Commonwealth of: Social Services Dept. for day, night & weekend numbers of appropriate regional office and to obtain copy of reporting form, so-called 51A form.
c. Chapter 265, Section 13I ASSAULT/BATTERY ON AN EMT
Whoever commits an assault or assault and battery on an emergency medical technician, an ambulance operator, or an ambulance attendant, while said technician, operator or attendant is treating or transporting, in the line of duty, a person, shall be punished by imprisonment in the house of correction for not less than ninety days nor more than two and one-half years, or by a fine of not less than five hundred not more than five thousand dollars, or both.
d. Chapter 266, Section 69 INSIGNIA USE
Whoever, not being a member of a society, association or labor union, for the purpose of representing that he is a member thereof, willfully wears or uses the insignia, ribbon, badge, rosette, button or emblem thereof, if it has been registered in the office of the state secretary, shall be punished by a fine of not more than twenty dollars or by imprisonment for not more than one month or both.
NOTE: Both the state and National Registry emblems are so protected. The "Star of Life" emblem is protected under the federal trademark act.
e. Chapter 111, Section 201 - FIRST RESPONDER LAW
Members of police and fire departments, members of the police force of the metropolitan district commission, the capitol police, members of the uniformed branch of the state police participating in highway patrol, persons appointed permanent or temporary lifeguards by the commonwealth or any of its political subdivisions, and members of emergency reserve units of a volunteer fire department or fire protection district shall be trained to administer first aid, including, but not limited to, cardiopulmonary resuscitation by July first, nineteen hundred and seventy-eight, including those appointed on or after January first, nineteen hundred and seventy-six. The training shall meet the standards for first aid training prescribed by the department and shall not be less than the standards established by the Committee on Cardiopulmonary Resuscitation and Emergency Cardiac Care of the American Heart Association, and shall be satisfactorily completed by them as soon as practical, but in no event more than one year after the date of their employment. Satisfactory completion of a refresher course approved by the department in cardiopulmonary resuscitation each year and in other first aid every three years shall also be required.
The department shall coordinate the provision, by county, of training required by this section. Such training shall be provided at no cost to the trainee. This section shall not apply to police officers, fire fighters and persons engaged in police and fire work whose duties are primarily clerical or administrative.
f. Chapter 19A, Section 15 ELDERLY ABUSE, MANDATED REPORTERS (excerpt)
Any physician, a medical intern, dentist, nurse, family counselor, probation officer, social worker, policeman, firefighter, emergency medical technician, licensed psychologist, coroner, registered physical therapist, registered occupational therapist, osteopath, podiatrist, executive director of a licensed home health agency, or executive director of a homemaker service agency who has reasonable cause to believe that an elderly person is suffering from or has died as a result of abuse, shall immediately make a verbal report of such information or cause a report to be made to the department or its designated agency and shall within forty-eight hours make a written report to the department or its designated agency. (underline added)
(the term 'department' in the excerpt refers to the Massachusetts Department of Elder Affairs which is a department of the state government)
g. Chapter 111, Section 111C REPORTING OF INFECTIOUS DISEASES DANGEROUS TO THE PUBLIC HEALTH
Any person, including without limitation, a police officer, fire fighter, emergency medical technician, corrections officer, ambulance operator or attendant who, while acting in his or her professional capacity, attends, assists, or transports a person to a health care facility licensed under section 51 of chapter 111, and who sustains an unprotected exposure capable of transmitting an infectious disease dangerous to the public health, shall immediately, upon arrival at such facility, provide to the admitting agent or other appropriate employee of the said facility a standardized trip form. The department shall prepare and distribute said standardized trip form, which shall include, but need not be limited to the names of persons who believe they have had such unprotected exposure, and the manner in which such exposure occurred.
"Infectious diseases dangerous to the public health" shall be defined by department regulations which shall be promulgated pursuant to this section.
"Unprotected exposure capable of transmitting an infectious disease dangerous to the public health" shall be defined in regulations promulgated by the department and shall include, but not be limited to, instances of direct mouth-to-mouth resuscitation, or co-mingling of the blood of the patient and the person who has transported the patient to the health care facility.
Any health care facility licensed under section 51 of chapter 111 which, after receiving a transported individual, diagnoses the individual as having an infectious disease dangerous to the public health as defined pursuant to the provisions of this section shall notify orally within 48 hours after making such a diagnosis, and in writing within 72 hours of such diagnosis, any individual listed on the trip report who has sustained an unprotected exposure which, in the opinion of the health care facility is capable of transmitting such disease. Such response shall include, but not be limited to, the appropriate medical precautions and treatments which should be taken by the party who has sustained the unprotected exposure; provided, however, that the identity of the patient suspected of having such disease shall not be released in such response, and shall be kept confidential in accordance with the provisions of section 70. The department shall determine the method by which the response to the trip report is conveyed, and shall assure the patient is informed of those individuals who have been notified of his her disease pursuant to this section, and that the response is directed only to those parties who have sustained an unprotected exposure to an infectious disease.
h. Chapter 111, Section 111C REPORTING OF INFECTIOUS DISEASES DANGEROUS TO THE PUBLIC HEALTH
Notwithstanding the provisions of any general law or special law to the contrary, no hospital, or agent, employee, administrator, doctor, official, or other representative of said reporting institution shall be held jointly or severally liable either as an institution, or personally, for reporting pursuant to the requirements of this section, if such report was made in good faith. All such parties, provided they have operated in good faith, shall otherwise be afforded total immunity from civil or criminal liability as a result of fulfilling the provisions of this section or the regulations promulgated in accordance with this section. (underline added)
(the term 'department' in the law refers to the Massachusetts Department of Public Health which is a department of the state government)
Please see also the regulations, 105 CMR 172.000 et seq., which are available from the State House Bookstore.
i. Chapter 111C, Section 10A (from the state EMS law)
An injured or sick child who is to be transported to a hospital or other medical treatment facility by an ambulance or other emergency vehicle shall be accompanied by a parent upon such parent's request, unless the emergency medical technician or other person in charge determines that the medical situation is life threatening or that the presence of a parent would create a potential risk to such child. Such determination shall be noted in the written report of said emergency medical technician and a copy of such report shall be sent to such parent within thirty days of such determination. (underline added)
NOTE: TO THE BEST OF OUR KNOWLEDGE, THESE LAWS ARE VALID AND/OR ACCURATE. WE WILL NEED TO RESEARCH EACH OF THESE LAWS TO MAKE SURE THEY HAVE SINCE BEEN AMENDED. IF THERE HAVE BEEN ANY CHANGES WITH ANY OF THE ENCLOSED LAWS OR REGULATIONS WE WILL AMEND THEM ACCORDINGLY.
NOTE: The following information is not presented in a legal format as the aforementioned material is.
This information is concerning when it is or is not appropriate to resuscitate a patient as well as the "Do Not Resuscitate" issue(s) involving terminally ill or other related patients and its impact on EMS. The first document is a copy of the current "MDPH/OEMS CPR Guidelines", first distributed in 1987. The DNR issue is addressed under the "TERMINAL ILLNESS" section (see enclosure) .
Please note, that in Massachusetts valid, original "DNR" orders are not currently, legally binding on EMTs in the pre-hospital setting, unless the EMT chooses to honor the written DNR order. EMTs are free either to "honor" a valid "DNR order", or to disregard the "order" and provide treatment and transportation, as required in the state EMS regulations.
The state EMS regulations, 105 CMR 170.255, mandate that ambulance services and their employees must respond to emergencies and they must render treatment (underline added) and they must provide transportation to all patients, without any exceptions. The actual regulation is quoted at the end of the enclosed CPR guidelines.
DNR orders, written by physicians, are not yet legally binding on EMTs, since there is no established legal relationship between physicians and EMTs, nor is there any statute establishing the legal status of DNR orders, especially in the pre-hospital care setting, to date.
Please note also that DNR orders are also capable of being "voided" at any time by the patient, physician, health care facility staff and/or family members (e.g. calling for help or an ambulance "voids" the DNR order) . This might occur in the home, hospice and/or health care facility setting.
(see MDPH/DHCQ "Guidelines for Nursing Homes and DNR Orders")
If an EMT chooses to honor the DNR order, we advise the EMT to attach the original DNR order, or a valid copy to the completed trip sheet, leave the body where it is, advise the family or other responsible parties to contact the physician/nurse/hospice for advice and to return to active service immediately.
If the EMT is not presented with a valid DNR order or cannot immediately verify with the physician, that a valid DNR order exists, the EMTs must treat and transport the patient.
The CPR Guidelines were meant to address the issue of the cardiac arrest in the home and/or hospice setting. Patients in a health care facility (nursing or rest home) present the EMS system with another set of issues. It is not unusual for physician's orders to be updated every 90 days in such settings. Again, the validity of the order may need to be verified, but if the written DNR order otherwise meets the guidelines listed in the AHA CPR Guidelines (JAMA), the EMT may honor the order.
If a patient, with a valid DNR order, expires in an ambulance, the EMTs are confronted with a very difficult decision. If they are to honor the DNR order, there must be a signed, written directive from the patient's physician or from the "sending" facility, that informs the EMTs where to transport the "dead body". Many "receiving" facilities (hospitals) are rightfully refusing to accept a "dead body". There are also instances where the "sending" facility (nursing home) has also refused to accept the "dead body" back from the ambulance service.
Several instances have already occurred where "dead bodies" have remained in the back of an ambulance for many hours, because the EMTs could not properly dispose of the "dead body". The "receiving" hospital and the "sending" nursing home both refused to accept the "dead body".
In one instance, when the medical examiner was contacted and finally arrived on scene, the medical examiner forcefully reminded the EMTs that it is illegal to transport a "dead body" in anything except a licensed hearse. The EMTs were also reminded that they should not be moving dead bodies from where they died, nor, in one case, should they have crossed a county line while transporting the "dead body".
Hospital staff have reminded the EMTs that hospitals are not in the business of pronouncing people dead and the EMTs had no business bringing a dead body to a hospital. Funeral homes would not accept the "dead body" without a signed death certificate.
It is our understanding that neither hospitals nor ambulance services can receive reimbursement for pronouncing a person dead or for moving a "dead body". Insurance reimbursement is apparently contingent upon providing appropriate medical care and/or medically necessary transportation.
Unless an established written mechanism exists to relieve the EMTs of a "dead body", it is our opinion that the EMTs and their employers must adhere to the requirements in the state EMS regulations, (105 CMR 170.255) , and provide appropriate EMT level treatment and transportation, when actually transporting a patient who has a valid, written DNR order.
The issue of whether an ambulance can transport a dead body is very clear. Under 105 CMR 170.260, ambulances are generally prohibited from transporting a dead body, except "...where it is in the interest of public health and/or safety to do so." The cases we envisaged, when we adopted that regulation, were those involving bodies in a public setting (e.g. on a highway), that needed to be cleared quickly.
In addition, the state regulations governing funeral homes (239 CMR 3.10) also prohibits any vehicle, other than a certified hearse, from moving a dead body.