Discuss the EMT’s role and obligations if a patient refuses treatment or transport.

Who has the right to refuse treatment?

Adults who are conscious, alert, and appear to have decision-making capacity—even if refusal could result in death or serious injury.

Who should you involve when a patient refuses treatment?

Online medical control, and document the consultation.

How do you assess a patient’s ability to make an informed decision?

Ask and repeat questions, assess answers, and observe behavior.

If a patient appears confused or delusional, what should you assume about their refusal?

It is not an informed refusal.

How should patients who have attempted suicide or expressed suicidal intent be regarded?

As not having normal mental capacity to refuse treatment.

What should you do to maintain your own safety if a patient refusing care becomes threatening?

Do not endanger yourself; request assistance from law enforcement.

What should you encourage a patient to do if they initially refuse care?

Permit treatment if possible, and call 9-1-1 if they change their mind or their condition worsens.

What advice should you give a patient who refuses treatment?

Contact their personal physician as soon as possible.

What form should you ask the patient to sign when refusing care?

A refusal of treatment form.

Whose signature should witness the patient’s refusal form to protect you from claims of negligence or abandonment?

A family member or a police officer.

If you cannot persuade the patient, guardian, or parent to accept treatment, what should you obtain?

The individual’s signature on an official release form acknowledging refusal.

Who should witness the patient’s refusal?

A responsible person such as a police officer.

Why is it important to retain the refusal documents?

They may be crucial if a legal claim is filed later.

What should you do if the patient refuses to sign the release form?

Inform medical control and thoroughly document the situation and the refusal.

If you cannot persuade the patient, guardian, or parent to accept treatment, what should you obtain?

The individual’s signature on an official release form acknowledging refusal.

Who should witness the patient’s refusal?

A responsible person such as a police officer.

Why is it important to retain the refusal documents?

They may be crucial if a legal claim is filed later.

What should you do if the patient refuses to sign the release form?

Inform medical control and thoroughly document the situation and the refusal.

What key details must be documented in the patient care report (PCR) when a patient refuses care?

• Your assessment of the patient’s condition
• The treatment you feel is necessary
• Possible risks of the treatment
• Availability of alternative treatments
• Possible consequences of refusing treatment.

What should your documentation include when a patient refuses care?

• Any assessment findings you were able to make
• All efforts made to obtain consent
• Possible consequences of refusing treatment and transport.

What key details must you document when treatment is refused?

• Any assessment findings
• The emergency care you provided
• Your efforts to obtain consent
• Your consultation with medical control
• The responses to your efforts.