Got really drunk and Paramedics were called

[DwayneEMTP]

I agree with much of what you say Dwayne, unfortunately the law is what legally requires us to decide for this man. Because he is intoxicated he is considered non compos mentis and therefore cannot make his own decisions. Courts hold bars responsible if they serve alcohol to someone and then that person gets hurt or hurts someone else. Casinos are responsible for making sure people who drink don't lose too much money. It goes on from there.

I agree Doc. I'm not saying that I can't get jammed up for leaving him, but I still have the question....if he chooses to make me sorry for taking him, what legal defense will I use to defend myself against forcefully removing him from his home against his will. Might it be the right thing to do? Maybe, but what makes it legal as long as he is alert enough to argue and resist but not legally able to sign a refusal?

To what law, or statute, or legal expectation will I direct the judge when we're in court?

Now, don't misunderstand, I'm not arguing to leave him because I'm afraid of being sued, I'm arguing to leave a small, select group of 'hims' because I believe that it is the right thing to do. But to our friends that are very cavalier about just tossing him on the cot and taking him against his will because he can't legally refuse, how can they legally defend that? I'm directing this to you as they seem to become terribly quiet each time I pose the question...

Dwayne

[ERDoc]

I agree Doc. I'm not saying that I can't get jammed up for leaving him, but I still have the question....if he chooses to make me sorry for taking him, what legal defense will I use to defend myself against forcefully removing him from his home against his will. Might it be the right thing to do? Maybe, but what makes it legal as long as he is alert enough to argue and resist but not legally able to sign a refusal?

To what law, or statute, or legal expectation will I direct the judge when we're in court?

Now, don't misunderstand, I'm not arguing to leave him because I'm afraid of being sued, I'm arguing to leave a small, select group of 'hims' because I believe that it is the right thing to do. But to our friends that are very cavalier about just tossing him on the cot and taking him against his will because he can't legally refuse, how can they legally defend that? I'm directing this to you as they seem to become terribly quiet each time I pose the question...

Dwayne

I think I see the issue here. It is not good enough from a legal standpoint to be alert enough to say no or take a swing at someone. In order to be able to refuse you have to be competent. Being alert and being competent are not the same thing. In order to be competent you have to understand what is wrong (to a layperson level, you don't have to understand the molecular physiology), you have to understand why it is important to get treated and you have to understand what could happen if you do not get treated. If they cannot repeat this back to you and show you that they have a full understanding of what is going on, then they cannot refuse. Take a look at the table in that NEJM article I posted above, it has lots of good stuff.

It pisses me off that if you make the decision to get drunk that you then become my responsibility but that is the way the law is. If you make the decision to get drunk, you alone should be responsible for what happens to you (I mean you as in a general term, not you specifically Dwayne.)

[HERBIE1]

I agree Doc. I'm not saying that I can't get jammed up for leaving him, but I still have the question....if he chooses to make me sorry for taking him, what legal defense will I use to defend myself against forcefully removing him from his home against his will. Might it be the right thing to do? Maybe, but what makes it legal as long as he is alert enough to argue and resist but not legally able to sign a refusal?

To what law, or statute, or legal expectation will I direct the judge when we're in court?

Now, don't misunderstand, I'm not arguing to leave him because I'm afraid of being sued, I'm arguing to leave a small, select group of 'hims' because I believe that it is the right thing to do. But to our friends that are very cavalier about just tossing him on the cot and taking him against his will because he can't legally refuse, how can they legally defend that? I'm directing this to you as they seem to become terribly quiet each time I pose the question...

Dwayne

I understand what you are saying, Dwayne. In the OP, if this guy was so drunk that he needed to be awakened, I highly doubt that he was competent when they finally did arose him- especially since he has no recollection of the incident. Is it possible the person was completely lucid? We all have seen professional drinkers who can appear to be and act stone cold sober and unimpaired- even if they are double the legal limit. To me this is a judgement call, and obviously this is about the purpose of the call. If it is for an injury and the person turns out to be uninjured- yet drinking, what do you do? To me, that's when things get fuzzy. If you are called for the unconscious person, it turns out they were drinking, then yes, they need to go. If they were so drunk someone could not wake them up, then they do pose at least an aspiration danger to themself- beyond the legal issue of being capable to refuse treatment and transport.. That would be when I bring LEO into the picture, if necessary.

With these fuzzy scenarios, like anything I would paint the proper picture for medical control, give my reasons why I think this person who admittedly has been drinking IS competent to refuse. I've done it many times, and never once been refused. It's called judgment, experience, and common sense. It's the old cookbook medic syndrome. It's easy to blindly follow rules and SOP's- which often are more about CYA of the agency or municipality than what may be best for the patient-vs assessing the patient, getting the whole story, and THEN deciding on a course of action.

Before lawyers become our partners in medicine, cops routinely would take a drunk home or call them a taxi, vs dragging them to an ER, calling for EMS or arresting them. Now, with everyone who has been drinking it is assumed they will go to bed and promptly vomit, aspirate, and die. They must be brought by ambulance- big bill- to an ER- bigger bill- so they can sleep it off.

Here is an example of a common issue for most urban providers. You get called for a man down, or something similar. A concerned citizen drives by(never stops, of course) and calls EMS. You find a homeless guy, sleeping on the sidewalk, on a bench, in an alley, etc. You wake them up, they say they are fine, did not call, do not need assistance of any kind. You KNOW this person probably has a baseline ETOH level that would make you unconscious. Does this person NEED to be transported? Not in my book. Done it literally thousands of times. Legal? Probably not. Will I do it the same way again? Yep.

Does my attitude make me a "cowboy", reckless, or a poor provider? I guess that depends on who you ask.

[ERDoc]

I understand what you are saying, Dwayne. In the OP, if this guy was so drunk that he needed to be awakened, I highly doubt that he was competent when they finally did arose him- especially since he has no recollection of the incident. Is it possible the person was completely lucid? We all have seen professional drinkers who can appear to be and act stone cold sober and unimpaired- even if they are double the legal limit. To me this is a judgement call, and obviously this is about the purpose of the call. If it is for an injury and the person turns out to be uninjured- yet drinking, what do you do? To me, that's when things get fuzzy. If you are called for the unconscious person, it turns out they were drinking, then yes, they need to go. If they were so drunk someone could not wake them up, then they do pose at least an aspiration danger to themself- beyond the legal issue of being capable to refuse treatment and transport.. That would be when I bring LEO into the picture, if necessary.

With these fuzzy scenarios, like anything I would paint the proper picture for medical control, give my reasons why I think this person who admittedly has been drinking IS competent to refuse. I've done it many times, and never once been refused. It's called judgment, experience, and common sense. It's the old cookbook medic syndrome. It's easy to blindly follow rules and SOP's- which often are more about CYA of the agency or municipality than what may be best for the patient-vs assessing the patient, getting the whole story, and THEN deciding on a course of action.

Before lawyers become our partners in medicine, cops routinely would take a drunk home or call them a taxi, vs dragging them to an ER, calling for EMS or arresting them. Now, with everyone who has been drinking it is assumed they will go to bed and promptly vomit, aspirate, and die. They must be brought by ambulance- big bill- to an ER- bigger bill- so they can sleep it off.

Here is an example of a common issue for most urban providers. You get called for a man down, or something similar. A concerned citizen drives by(never stops, of course) and calls EMS. You find a homeless guy, sleeping on the sidewalk, on a bench, in an alley, etc. You wake them up, they say they are fine, did not call, do not need assistance of any kind. You KNOW this person probably has a baseline ETOH level that would make you unconscious. Does this person NEED to be transported? Not in my book. Done it literally thousands of times. Legal? Probably not. Will I do it the same way again? Yep.

Does my attitude make me a "cowboy", reckless, or a poor provider? I guess that depends on who you ask.

Herbie, I don't see a problem with not transporting in that case. It's obvious the person was just sleeping, there is no concern that he fell and he is easily arousable then you could argue that there is no pt. Yeah, if he gets up and staggers into traffic after you leave, you'll be on the hook but I would agree that there is no reason to take him.