Can ER patients refuse treatment?

[Michael]

[web:7f57357640]http://ap.google.com/article/ALeqM5gn7nIqTvF7zSx6NAjqcHp5xD5AUAD8U731IG0[/web:7f57357640]

[JPINFV]

While I believe that it's normally bad form to link to other forum discussions (ex: I wouldn't link this forum to another EMS forum and vice versa), I think that it's different when discussing things that fall, in part, out of the purview of the original forum.

The Emergency Medicine Resident Forum over at Student Doctor Network had a lively discussion over this already.

Man sodomized in NYC ED

Funny related image, not safe for non-medical jobs.

[spoil:fd79a04062][web:fd79a04062]http://forums.studentdoctor.net/attachment.php?attachmentid=6948&d=1159498478[/web:fd79a04062][/spoil:fd79a04062]

[AnthonyM83]

Was he altered? Isn't this common when coming in with a trauma? Some resident always checks for rectal tone...

[Medic26]

Just some fine american trying to make a quick buck. $$$$$ Its all about lawsuits nowadays. :roll:

[Michael]

Good link, JP, thanks.

[Just Plain Ruff]

ok put yourselves in this guys shoes.

We don't have the whole story but if the guy was alert enough to refuse a rectal exam why did they need to do the following

1. give him an injection (I'd assume that was for the RSI)

2. Then tube him

3 and then rectal exam him?

If the rectal exam is supposed to check for spinal cord injury wouldn't the results be skewed by the fact that he is paralyzed?

If you said no rectal exam and they did one anyway what would your thoughts or responses be?

Plus why did he spend 3 days in a detention center? Sounds like overkill on the part of the hospital to me. This seems like a valid case if you ask me.

[Eydawn]

If he was competent, GCS 15, etc. then he should have been offered an AMA as far as the butt-probing went.

If he was not competent, or combative prior to the initiation of the butt probe, and it has been properly documented, then the hospital can prove they were acting in the best interests of a patient who was not competent enough to refuse care, and he has no case (or at least a harder time of screwing the ED).

I'm sorry.. you can prove that you've developed PTSD from darn near anything (referencing SDN thread) legitimate or otherwise... but you can't sue your doctor for suddenly being afraid of alcohol wipes, for example...

It all depends on the paper trail. Once we find out what the hospital actually did and documented, then we'll know how it is probably going to turn out.

Wendy

CO EMT-B

[Ecnalubma08]

YES!!! And if psychosis is a problem...."hospital level of care" will be given.

[zippyRN]

as has already been said - it deepdnds on the whole story i'm wondering given the discription made whether the Trauma team thought he'd got a head injury and was combative ... hit o nthe forehead by a wooden beam s and combative sounds like a very good indication for a tube and ride on the donut of death

like the time a patient's realtive acused me of 'shouting at' and 'assaulting' the patient ...

that would be the patient with an intracerebral bleed who was on regular neuro obs and at that time was GCS 8 (e1-2 v1-2 m5 depending on the assessment at that time) ...

( think about it , how do you assess someone's GCS)

[gvandellen]

If anybody has watched trauma team at work then you know this case has no merit. A patient is log rolled of a spine board, the patient's back is checked for step off, and a quick rectal is done. It's procedure and it is done in the best interest of the patient for any possible spinal injury. They tell you about 2 seconds before the finger goes in. If he objected then it was while the finger was in and then he freaked. Of course the hospital will settle out of court and he will walk away with money.