Can ER patients refuse treatment?

[Boolancedriver911]

As long as they are conscious, alert and oriented to all appropriate questions, the they can refuse,, right??

[MSDeltaFlt]

As long as they are conscious, alert and oriented to all appropriate questions, the they can refuse,, right??

It's a bit more complicated than that as is stated above.

[Eydawn]

Then it must just be Colorado (that we know of) that the developmentally disabled have full rights, regardless of mental capacity. That's interesting, to be honest! Since the de-instutionalization movement in the 60's-70's, it's been up to each state... I just didn't realize how different it was between states. My bad!

In the State of Colorado persons who are developmentally disabled are considered to be their own legal guardians upon reaching the age of 18, unless they have a state or court appointed guardian. This means they have the full legal right to refuse medical or other care, just like any other adult.

In the State of Colorado, *regardless* of the developmentally disabled person's ability to fully comprehend and explain the ramifications of treatment, if they are their own guardian, they LEGALLY can refuse. They also must sign all of their own legal documents and other materials; it is illegal for anyone else to sign for them.

For example... an individual with DD with very advanced and detrimental diabetes is his own guardian. He refuses to bathe, care for his diabetes, or otherwise take care of his health.. and cannot be forced to do any of the above.

Here's why I think this is in our state... I think Colorado is primarily concerned with preserving the right to independent decision and personal and legal rights of those citizens with developmental disabilities, EVEN THOUGH this may mean allowing people who COULD be forced to care for themselves or who COULD be forced to take important medication to refuse, and thereby cause harm to themselves.

Believe me... it's really frustrating in the case of some of my clients where they refuse medications and become ill... but it *is* their legal right.

ERDoc, thanks for pointing out the differences in other states, but rest assured that my fiancee and others like him in this field in Colorado are well versed in the laws (frustrating though they may be) because they have to deal with them on a daily basis.

So, everyone, check to see what your state's rules and regs are concerning the ability to refuse care if you are developmentally delayed... just in case you try to force treatment on someone who's higher functioning or has snarky relatives and there's no clause for it in your state laws.... it's always better to know in advance where you're protected and where you aren't.

You also can't just ask the parents if they are an adult's legal guardian; there are many parents of people who are developmentally disabled who are *convinced* that they are still the person's guardian, but have not gone through the mountain of paperwork to gain guardianship of their adult offspring, and thus the DD person has every right to refuse care, regardless of what the parents want. Again, this applies to the State of Colorado.

Wendy

CO EMT-B

[zippyRN]

from a rightpondian point of view aobut capacity and consent

the law assumes people have capacity and therefore can consent - this is definitely the case once you are 16 and may be the case before that age the concept of 'Gillick competence' often referred to in he Uk

however there is a common law duty of care to act i nthe best interests of patients which can include undertaking interventions if it is felt that someone does not have capacity

it is a minefield for the unwary regarldess of the exact locally relevent statutes

[Dustdevil]

It's a bit more complicated than that as is stated above.

Not to mention that we can't even agree upon what "all appropriate questions" are. I have yet to see any EMT school teach them to a medico-legal certainty.

[MSDeltaFlt]

Not to mention that we can't even agree upon what "all appropriate questions" are. I have yet to see any EMT school teach them to a medico-legal certainty.

We are kind of thrown to the wolves upon graduation, aren't we?