Informed consent is extremely important in treating the emergency patient. Remember that consent can be written, verbal, or implied. Treating a patient without consent, even if it is to do something like starting an IV, can be called battery. Most consent in EMS care is implied unless the patient is alert, oriented, and able to sign a consent form. Implied consent involves caring for the patient who cannot give consent but any reasonable person would give similar consent if able to. People under the age of 18 years cannot give consent legally so a parent or legal guardian must give consent for them. A teacher or principal of the school will be able to give consent until the legal guardian becomes available. Only emancipated minors, such as those who are pregnant, in the armed services, or who are married are considered legally emancipated. Any adult or emancipated minor has the write to refuse medical care, regardless of reason. This is true, even if the lack of treatment is detrimental to themselves. What you have to do is prove that the patient understands the risks of treatment, the benefits, and the alternatives available. The EMS provider should document whether or not the patient has the capacity to refuse treatment. If things like restraints are necessary but refused, you should document why they are best for the patient’s safety or the safety of others. One federal law that is followed is the federal HIPAA law. This law specifically addresses confidentiality of patient care with the only exception being mandatory reporting. Mandatory reporting is necessary for things like gunshot victims, stabbings, sexual assault, elder abuse, or child abuse. EMS providers are mandatory reporters of these kinds of things.
CULTURAL ISSUES Healthcare in just about any part of the US can be complicated by language and cultural barriers. There are features of the western medical system that are not shared by everyone who receives it. There are differences in the medical concept of disease and the patient’s concept of illness. This is even more magnified when there are cultural
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