Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

What Allows EMS to Strip a Patient of Civil Rights

Happy Medic has a post about the guy in Florida who claims to have been kidnapped. Man Forced into Ambulance Ride, but Was He Kidnapped? I am more interested in the comments.

An unfortunately common statement is made supporting one of the mindless approaches to informed consent.

presence of any intoxicants renders a patient unable to make transport decisions, that is, they can’t make their own choices.

Joe Paczkowski makes some good points about the silliness of this approach.

I take this a bit farther. I do take this to absurd extremes, but this is an example of an absurd extreme in depriving patients of informed consent.

If we are going to throw out a patient’s civil rights any time that any intoxicant is present, where does that end?

We certainly do not want anyone in EMS using their judgment to determine if the patient is impaired. We just want a rule that can be satisfied by a check box.

A. Intoxicant present.

B. No intoxicant present.

It does not matter if the person is the designated driver and has not consumed any of the intoxicant. An intoxicant is present, therefore the guilt by proximity rule is in effect and we can do whatever we want to the poor sucker.

Then there is the problem of what is an intoxicant?

Cough medicines often contain alcohol.

Other medicines may contain alcohol as a preservative, but an alcohol is an alcohol, no matter how small.

Should we abduct everyone who has taken a medicine containing alcohol.

What about all of the other medicines that could be intoxicants?

The better question is What is not an intoxicant?

All things are poison and nothing is without poison, only the dose permits something not to be poisonous. – Paracelsus.

Is there any poison that cannot be described as an intoxicant?

If everything (all things) is a poison, then the presence of anything renders a patient unable to make transport decisions, that is, they can’t make their own choices.

In other words, nobody has any right to make any independent decision once EMS shows up.

Power hungry?

Maybe.

Delusional?

Probably.

Dangerous?

Definitely.

Better able to make decisions for patients than the patients?

Absolutely not.

All this to prevent EMS from making decisions based on an actual assessment of the patient.

This is very dangerous.

.

Comments

  1. Well said sir. How about the response we’ve all heard from some power hungry, Napoleonistic first responder who says “He’s drunk, he can’t make any decisions, you have to take him to the hospital”. My response is usually something along the lines of the fact that this is still America last time I checked and not Mother Russia and that really if he’s still awake, alert and appropriate the decision will lie between him and the kind police officer as to what he can and can’t do and I’m just here to take him to the ER if he chooses that is indeed what he’d like to do.

    But, that could just be me suffering from a Napoleon complex…..but I’m not short……hmmmm…or am I? Hmmmm…..

  2. Thanks for the link Rogue. I am lucky in my service to have the grey area built into my refusal forms “Patient does not appear to be under the influence of drugs or alcohol” which not only gives me a lot of wiggle room, but also serves to help get the fence sitters to go when I think it necessary.
    Too many systems threaten their medics and EMTs with lies about kidnapping, charts blown up in court and ripped apart by lawyers etc so convince them refusals are dangerous.

    The definition of “impaired” was discussed by myself and Motocop on a recent podcast and we learned, no surprise here, that we have two completely different definitions for two completely different reasons.

    Thanks again,
    Justin

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