Week 6- Consent and ROS

Question 1

What do you need to tell the patient?

Answer 1

1. Nature of the treatment
2. Expected benefits
3. Material risks
4. Material side effects
5. Alternatives
6. Likely consequences if its not done
7. Chance to ask questions and get answers

Question 2

What is implied consent?

Answer 2

• Consent for treatment that is presumed for a patient who is mentally, physically, emotionally unable to give consent
• It is assumed that a patient would want life saving treatment if able to give consent
• Also called emergency doctrine

Question 3

What is expressed consent?

Answer 3

• Is verbal, non-verbal, or written communication by a patient who wishes to receive treatment
• The act of calling for EMS is generally considered an expression of the desire to receive treatment
• You must obtain consent for each treatment provided

Question 4

When a patient is experiencing severe suffering or is at risk and delay will result in serious bodily harm if tx not delivered. A paramedic may administer tx without Consent & in the opinion of the Medic…

Answer 4

1. The pt is not capable of giving consent or refusing tx AND
2. Delay required to obtain consent on the pt’s behalf will result in harm or increasing suffering

ADMINISTER TREATMENT WITHOUT CONSENT

Question 5

Special Consent Situations

Answer 5

Minors
- usually a person under 18 yrs of age
- consent must be obtained from a parent or legal guardian

Question 6

What is Valid Consent?

Answer 6

To receive valid informed consent, three components must be present:

1. Disclosure you tell them everything
2. Capacity in your opinion is present
3. Voluntariness pt. is not refusing

Question 7

What are the special situations?

Answer 7

• Court orders
• The mental health act

Question 8

What is involuntary consent?

Answer 8

Consent for treatment granted by a court order

• Most commonly with pts who must be held for mental health evaluation or as directed by law enforcement personnel who have the pt under arrest
• May be used on pts whose disease threatens a community at large

Question 9

A patient, if capable, can withdraw consent?

Answer 9

• A patient may withdraw consent for treatment at any time, but it must be an informed refusal of treatment
• Sign & Decline…

Question 10

What are the 2 legal implications surrounding consent?

Answer 10

Abandonment & Assault

Question 11

Abandonment

Answer 11

• is the termination of the paramedic patient relationship without assurance that an equal or greater of care will continue

Question 12

Assault

Answer 12

• is the act of unlawfully placing a person in apprehension of immediate bodily harm without his or her consent

Question 13

Restraining a Violent Patient

Answer 13

• Need police
• Could be considered assault, causing bodily harm

Question 14

Refusal of Service

Answer 14

• Not every EMS run results in the transportation of the patient to the hospital
• Emergency care must always be offered to the patient, no matter how minor the injury or illness

Question 15

If a patient refuses…

Answer 15

• Is the pt legally permitted to refuse care?
• Make multiple, sincere attempts to convince the pt to accept care
• Make sure the pt is informed in his or her decision
• Consult with on line medical direction
• Have the pt sign
• Have a witness sign
• Advise the pt he/she may call again for help
• Attempt to get someone to stay with the pt
• Document the entire situation thoroughly

Question 16

Refusal of Care

Answer 16

If a patient Refusal of Treatment and/ or Transport

• Refusal consequences explained
• Documentation on ACR
• Emergency Treatment if required
• What to do if they won’t go? Violent?
• Capable of making the decision?

Question 17

Signatures

Answer 17

• Read the “Refusal of Service” to the patient, prior to having them sign & prior to witness signing. So everyone is “Clear” on what it means