police intercede

[BEorP]

I'll add another thought on why calling OLMC is not idea (again, I'm not arguing with anyone following their own agency's requirements though). Say you call and describe a patient who has capacity but also a potentially serious illness or injury and the doctor tells you to bring them to hospital. What happens then if the patient continues to refuse? If the patient has capacity, this is completely wrong. Even if the doctor would take some of the blame in the end if the patient pushed the issue after having been somehow forced to go to the hospital, surely the EMS providers should also be to blame. I don't feel like "I was just following orders" is a good reason to violate a patient's right to autonomy.

[ERDoc]

I also forgot to mention that our doc had to get on the phone and speak with the pt. Any doc that says to do that doesn't understand the law. You can tell a pt that they should and need to go otherwise they will die but as long as they have the capacity to make that decision, EMS and the doc can't make them go.

[Richard B the EMT]

I'll presume someone missed what I wrote. I did indicate (or thought I indicated) when contacting OLMC, the Dr. speaks with the patient as part of determining the patient's mental capacity, before requesting the field supervisor, and the LEOs.

Everyone's policies differ. If yours don't require contacting OLMC, don't. I have no issue, as long as local policy and protocols, while different from mine, are followed.

[Eydawn]

Boy, I'd be mad if someone was picking up on my patient being altered and didn't tell me... that changes my treatment dispo very quickly. I'd like to think that I'd figure out the person wasn't totally functional, but I'm human and make mistakes... if someone else is seeing what I can't see, why the hell wouldn't you speak up and say "no, look, this guy is altered because of XYZ and I really do think there's more than what we're seeing here..."

*Scratching brain* not sure why anyone WOULDN'T speak up... even with folks I don't work well with, clear and accurate communication is essential...

You can only nanny-state folks so much. At some point, individual competent autonomy has to have a say... like my patients with off-unit privileges who "go outside for a walk" and I know damn well they're going to smoke... I remind them it's a smoke free campus and tell 'em to take off their nicotine patches if they're hell bent on it... and let 'em be. Note, I will emphasize, COMPETENT autonomy...

Wendy

CO EMT-B

RN-ADN