Cgabryszek: Created page with "Notes: * This protocol addresses determining whether an individual has the capacity to refuse care and/or transport in the prehospital setting. * Determining if a patient has capacity to refuse care should be done systematically and carefully to ensure patient safety and protection of the crew. * For patients < 18 years old, contact medical control for management recommendations. {| class="wikitable" |'''EMR/EMT/AEMT/Intermediate/Paramedic''' |} A patient can ref..."

2025-05-07T21:17:59Z

Created page with "Notes: * This protocol addresses determining whether an individual has the capacity to refuse care and/or transport in the prehospital setting. * Determining if a patient has capacity to refuse care should be done systematically and carefully to ensure patient safety and protection of the crew. * For patients < 18 years old, contact medical control for management recommendations. {| class="wikitable" |'''EMR/EMT/AEMT/Intermediate/Paramedic''' |} A patient can ref..."

New page

Notes:

* This protocol addresses determining whether an individual has the capacity to refuse care and/or transport in the prehospital setting.
* Determining if a patient has capacity to refuse care should be done systematically and carefully to ensure patient safety and protection of the crew.
* For patients < 18 years old, contact medical control for management recommendations.

{| class="wikitable"
|'''EMR/EMT/AEMT/Intermediate/Paramedic'''
|}

A patient can refuse care/transport if these 3 criteria are met:

# '''Patient demonstrates understanding of information relevant to the decision in question.'''
## Understands that there they may have a medical issue and why there is concern for decompensation.
# '''Patient has the ability to weigh risks and benefits, and to assess alternative options.'''
## Transport with EMS for ongoing assessment/care and to ED for further evaluation.
## Private transport without ability to have ongoing assessment/care—risk of deterioration or death.
## No transport for evaluation—risk of deterioration or death.
# '''Patient can communicate clearly with medical providers about the decision in question, and verbalize the ultimate decision.'''
## (Patient makes statement, “I have decided X because of Y, knowing that Z could happen.”)

'''Notes:'''

# The patient must be consistent when the provider is assessing these areas.
# Providers must also clearly document this conversation occurred, and an impression as to whether patient demonstrates capacity in medical decision making.
# Prehospital providers are capable to make this assessment. However, if there are any concerns or questions establishing capacity, medical control should be contacted.
# If uncertainty exists about a patient’s ability to demonstrate capacity and the provider has concern about the necessity of a medical evaluation and the patient refuses, consider involving law enforcement.
# Occasionally, a patient may not be able to fully demonstrate capacity. If no significant or immediate concerns exist, the provider may consider leaving the patient with an associate/family member/friend who is determined to have capacity and agrees to the care plan of the individual in question and will pursue further evaluation if the status of the patient changes.
# If there is concern for a suicide attempt or suicidal ideation, law enforcement MUST be involved if the patient is determined to have decision making capacity - but is refusing transport.

5-12 DETERMINATION OF CAPACITY - Revision history