Neal Warrer

Lets see here, the guy has his leg all but amputated, but doesn't want immediate care. We don't know what his reason was because the OP admits he's forgotten it. But, it's pretty fair to believe that there was no good reason. Thus, he's not making a decision competently. But, that's fine, you get to have an opinion, too, No we don't force everyone to go against their will in our system. The other side of the coin is the I live and work in one of the most litigious states in America. So sometimes the people that make the rules are going to err on the side of caution. That's why we have someone above us in the chain who can give orders and take the liability off of us. It's also why I took the time to make the point that other system policy's and procedures would likely vary.

I agree with those who suggest that you can ethically take this person against his will, as being a threat to himself. In fact, I have in the past, contacted my resource hospital for their orders to do just exactly that in a medical run. The person was clearly in need of medical care, was anwering all questions clearly and correctly, yet was refusing transport. I contacted the resource hospital, either to document the refusal or better yet to get the order to transport against the subjects will. The ER Dr. agreed with my assessment that this person required medical care, and that refusal to seek it was tantamount to having an altered mental status and made the PT a threat to themself. Of course, other systems rules and policies may, and probably will, vary.