1-13 PATIENT REFUSAL FOR MEDICAL CARE-TRANSPORT
If the patient refuses medical care at the scene or transport to the hospital, and in the opinion of the EMT-Basic or EMT-Paramedic team and/or the medical control physician, the patient does not have decision making capacity (i.e. drug/alcohol intoxication, medically compromised, psychotic etc.) and the patient requires immediate medical attention to prevent loss of life or permanent impairment, transport should be initiated. If necessary, the appropriate police agency should be contacted for assistance with, and preparation for Emergency Detention based on EMS/Medical determination of "imminent danger".
A patient that has decision-making capacity has the right to refuse transport even if a life threatening or permanently disabling condition is perceived by the treatment team. The concern for a life threatening or permanently disabling condition must be explained to the patient declining transport.
If the patient refuses medical care at the scene or transport to the hospital, and if the treating team does not believe a loss of life or permanent impairment will result and the patient is felt to have decision making capacity by the team, in consultation with medical control if appropriate, then the patient will be asked to sign a release form containing the following information at a minimum:
- Patient’s name, address and age
- Chief complaint necessitating the initial response
- Findings of the paramedic assessment including vital signs
- Signature of witnesses (preferably a police officer or family member)
Documentation of care should be completed for all patients signing a release.
Release forms should also be completed for transported patients refusing portions of indicated medical care (i.e. cervical spine immobilization, IV etc.)
