Patient Rights and Refusal of Care

Questions and Answers

What is a competent adult's right in regards to medical care?

To make decisions about their health care and refuse medical care after being properly informed of the benefits, risks, and alternatives.

What is the first step in allowing a patient to refuse care and/or transport?

Perform a complete assessment, maintaining suspicion of serious illness or injury.

What should you avoid when evaluating the differential of possible medical conditions?

Tunnel-vision on only one explanation for the patient's condition.

What factors could impede or impair a patient's comprehension and decision making capacity?

Clinical, physical, and emotional disturbances. Signup and view all the answers

What is necessary to determine about a patient's mental status?

Their ability to make an informed refusal, including evaluating choices, understanding risks and benefits, and having the capacity to make rational decisions. Signup and view all the answers

How should the patient be offered transport?

In a polite and unqualified manner. Signup and view all the answers

What must be communicated clearly to the patient?

Worst case possibilities of their medical condition. Signup and view all the answers

What must be evaluated for a patient's legal representative making a refusal request?

Their mental status, including their ability to evaluate choices, understand risks and benefits, and have the capacity to make rational decisions. Signup and view all the answers

Study Notes

Patient Rights and Refusal of Care

Competent adults can make informed decisions regarding their health care, including the right to refuse recommended medical care.
Patients must be fully informed about the benefits, risks, and alternatives of the proposed treatment before refusing care.

Protocol for Refusal and Non-Transport

A structured protocol must be followed when a patient who summoned EMS refuses care or transport.
Each interaction with a patient refusing treatment must adhere to established steps to protect both the patient and EMS providers.

Assessment and Evaluation Steps

Conduct a thorough assessment of the patient to identify serious illness or injury, maintaining a broad perspective on possible conditions.
Differences in potential medical conditions should be evaluated rather than focusing solely on one explanation; anticipate worst-case scenarios.
Communicate any concerning findings to the patient or legal representatives clearly and compassionately.

Mental Status Considerations

Confirm the patient's mental status, ensuring they are alert and oriented to time, place, and events.
Evaluate the patient's ability to make informed decisions while understanding risks, benefits, and choices available.
Identify any clinical, physical, or emotional disturbances that might impact the patient's decision-making ability.
If a legal representative is present, assess their mental status similarly to ensure sound judgment.

Offering Transport

Always offer transport to the patient or their legal representatives in a polite and straightforward manner.
Avoid any actions that may be perceived as discouraging or not supporting transport, as these may lead to legal implications.

Legal Representatives and Capacity

Legal representatives can refuse care only if they demonstrate capacity to understand the nature of the patient's condition and implications of refusal.
A person legally able to make medical decisions includes adults aged 18 or older and emancipated minors.
Legal authorities may include parents of minor patients or legal custodians with Durable Power of Attorney for Health Care.