Podcast
Questions and Answers
What is a competent adult's right in regards to medical care?
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?
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?
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?
What factors could impede or impair a patient's comprehension and decision making capacity?
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What is necessary to determine about a patient's mental status?
What is necessary to determine about a patient's mental status?
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How should the patient be offered transport?
How should the patient be offered transport?
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What must be communicated clearly to the patient?
What must be communicated clearly to the patient?
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What must be evaluated for a patient's legal representative making a refusal request?
What must be evaluated for a patient's legal representative making a refusal request?
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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.
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Description
Understand the rights of competent adults to refuse medical care and the protocol for refusal and non-transport in emergency medical services.
