Does a patient have the right to refuse?

[ffemt8978]

Does the patient have the right to refuse treatment based soley upon the gender of the EMS provider?

This was brought up in chat earlier, and the OP didn't have time to post the question for discussion.

 

[emtashleyb]

Eh thats kind of tough but I would say yes as long as they have their abc's and are alert and oriented. Im thinking about along the lines if you went to a rape call. Ive been raped and I didnt want a man to touch me again for a very long time so I would not want a male ems provider/doctor/nurse looking at or touching me.


...I forgot to add the if they are of age. Whos a moron? ME!

 

[KEVD18]

a patient who has reached the age of majority and has been deemed capable of cognitive thought can refuse tx/tp for whatever reason they so choose.

on a related note, can a patient refuse care from an emt of a particular race?

a few years back, i was working with a black gentleman. walter, nicest guy you could imagine. well we took a call for an mva. we got there and the driver/patient flipped out because a black emt was going to be working on him and refused to be touched. wanting to be diplomatic, walter and i confered and decided i would tech and he would drive. driver diagreedstating that he didnt trust him behind the wheel either. we went back and forth a bit and he autographed a refusal. my radio transmission clearing the scene was priceless:

operations, a2 we're clear of xx location with an ama refusal. please send a white crew for this call.
2, can you repeat that?
ops, yeah, the driver is refusing any evaluation, treatment or transportation by a black emt.
2, landline the ops supervisor immediately.

my partner is cracking up the whole time. he couldnt have cared less. my supp started to ream me otu, and then realized i wasnt really all that wrong.

 

[FF894]

a patient who has reached the age of majority and has been deemed capable of cognitive thought can refuse tx/tp for whatever reason they so choose.

on a related note, can a patient refuse care from an emt of a particular race?

a few years back, i was working with a black gentleman. walter, nicest guy you could imagine. well we took a call for an mva. we got there and the driver/patient flipped out because a black emt was going to be working on him and refused to be touched. wanting to be diplomatic, walter and i confered and decided i would tech and he would drive. driver diagreedstating that he didnt trust him behind the wheel either. we went back and forth a bit and he autographed a refusal. my radio transmission clearing the scene was priceless:

operations, a2 we're clear of xx location with an ama refusal. please send a white crew for this call.
2, can you repeat that?
ops, yeah, the driver is refusing any evaluation, treatment or transportation by a black emt.
2, landline the ops supervisor immediately.

my partner is cracking up the whole time. he couldnt have cared less. my supp started to ream me otu, and then realized i wasnt really all that wrong.

Sad and funny all in one

 

[FF894]

Good post - not sure if there is a right answer. Hope nobody takes this the wrong way, but I think females will have stronger opinions than males on the issue. Personally, if I have a female patient who is requesting a female for whatever reason and there is one availible then why not accomodate. However, if logistically there is no female availible then what?

I also think of why the ambulance is there in the first place? If they can refuse transport because they are A&OX4 and not dying in front of us, then do they need an ambulance for transport anways? Of course, it depends on the reason why we are there and there are arguments in both favors. If an emergency ambulance is on scene working on convinincing a fe/male patient to go with them because an opposite sex crew is the only crew available, meanwhile there is a patient who truly needs their services nearby who is waiting for the next ambulance miles away it's not doing either patient any good.

It really depends on the call dynamics- why are we there, where are we, etc., etc. Maybe bring a family member on board to mitigate the situation.

When it comes down to it though, if a patient is A&OX4 and of age- they can refuse for any reason they want.

 

[marineman]

Pt. doesn't need to tell you why there refusing. They could be having an MI and refuse transport because they don't want to miss the price is right. As long as you were there and did as much for the patient as they allowed and fully informed them of the risks of not seeking higher care you're in the clear and it's on them. That's the legal side. Ethics and morals may be a different side of the coin but that's your choice to make.

For exactly that reason the service I'm riding with has at least one female medic on duty at all times.

 

[Sasha]

A patient has a right to dictate who touches them, man, woman, black, white or green.

Isn't there a religion or region or something that forbids men being taken care of by a woman or woman being cared for by a man or something?

 

[KEVD18]

ive said it before, i couldnt possibly care less why a patient is refusing. as long as they meet the criteria for a refusal, its sign here and have a nice day. i dont assualt patients and i dont kidnap them

 

[el Murpharino]

Isn't there a religion or region or something that forbids men being taken care of by a woman or woman being cared for by a man or something?

Muslims practice this act...I have, on multiple occasions, had to respect the wishes of a Muslim woman who refused to have me treat her because I was a man. Fortunately I was able to get a female medic to assist in these cases.

 

[mycrofft]

...and see if it flies with a minor also. False imprisonment, kidnapping, battery...

You could argue racism/sexism/antisemitism etc are a form of mental illness, but I think DMSIII demands that they think those groups come from the planet Exador or something to be non compos.

OK, what's the bigger picture...whom would you leave and let die?

 

[KEVD18]

OK, what's the bigger picture...whom would you leave and let die?

anybody who meets the refusal criteria. seriously. this is my speach:

sir/ma'am: im required to inform you of the following. at this time, i am unable to completely establish whether or not you are suffering from a potentially life threatening illness/injury. the only person able to make that determination is a physician at the hospital. while i can not force you to go or take you against your will, i can strongly recommend that you allow me to transport you their for further evaluation. should you choose to refuse treatment or transportation, you accept full responsibility for any further progression of your injury or illness. you understand that this could include permanent disability or death. do you wish to be treated and transported or do you wish to refuse the services offered?"

if they meet the criteria and tell me after that they dont want to go with me, i will not lose one millisecond of sleep over it, even if they die eight minutes later. its not my problem anymore.

legal aspect aside, its the patients expressed wish that they not be treated nor transported at that time. doing anything else is contrary to the patients wishes. simple as that. ive had elderly patients who adamantly wanted to die in their own home. children show up and cant handle the though of letting mommy/daddy go so they call us. patient meets the criteria, sign here.

people have told me its cruel, heartless, lazy and a thousand other adjectives. i disagree. its none of the above. its the legal and ethical way to handle it.

 

[ffemt8978]

So what I'm seeing so far is that it is okay for patients to discriminate based upon gender, which means that it's also okay for patients to discriminate baced upon race, religion, or age.

Doesn't there have to be a line drawn somewhere? If a patient can pick and choose who they want to treat them, how many units are going to be taken out of service until they get one that they like?

Pt. - nope, I don't want to go to the hospital with you..you're all males.
EMS - Dispatch, we need a female ambulance crew
Pt. (after 2nd ambulance shows up) - No, I don't want to go with you...you're the wrong race.
EMS - Dispatch, we need a female ambulance crew of XXXX race
etc....

And what happens if your service doesn't have anybody that meets their criteria?

 

[Hastings]

Yes, they absolutely do.

If they're competent, they have right to refuse care for any reason. Even gender of provider. End of story.

That being said however, if it WAS gender, I'd try to accommodate the patient's preference so they get the care they may need.

----

As to the update: If they have unreasonable desires, and they refuse because it's not reasonable for you to meet their requests, then it's their call. They can refuse care, and you can leave. You don't really have an obligation to meet unreasonable requests that draw unreasonable amounts of resources, etc.

 

[KEVD18]

thats exactly why i think there should be stiff legal penalties for wasting resources.

 

[daedalus]

Stupidity is not a dx I can treat. If they refuse treatment and/or transport based on my or my partner's gender, race, or any other reason they will be told that death can and will result from said refusal and I will pack up and leave.

 

[daedalus]

So what I'm seeing so far is that it is okay for patients to discriminate based upon gender, which means that it's also okay for patients to discriminate baced upon race, religion, or age.

Doesn't there have to be a line drawn somewhere? If a patient can pick and choose who they want to treat them, how many units are going to be taken out of service until they get one that they like?

Pt. - nope, I don't want to go to the hospital with you..you're all males.
EMS - Dispatch, we need a female ambulance crew
Pt. (after 2nd ambulance shows up) - No, I don't want to go with you...you're the wrong race.
EMS - Dispatch, we need a female ambulance crew of XXXX race
etc....

And what happens if your service doesn't have anybody that meets their criteria?

That patient should be made to ether be transported with the ONE crew on scene, or signed out and fined and/or arrested for wasting 911 resources.

 

[FF894]

This, in addition to about 1482 other scenarios, is a good example of why there should be penalties for abusing the system. Don't see it happening anytime soon though.

 

[Sasha]

So what I'm seeing so far is that it is okay for patients to discriminate based upon gender, which means that it's also okay for patients to discriminate baced upon race, religion, or age.

Doesn't there have to be a line drawn somewhere? If a patient can pick and choose who they want to treat them, how many units are going to be taken out of service until they get one that they like?

Pt. - nope, I don't want to go to the hospital with you..you're all males.
EMS - Dispatch, we need a female ambulance crew
Pt. (after 2nd ambulance shows up) - No, I don't want to go with you...you're the wrong race.
EMS - Dispatch, we need a female ambulance crew of XXXX race
etc....

And what happens if your service doesn't have anybody that meets their criteria?

You don't do that. "You know you can die? Ok. Sign here. Please do not hesitate to call back if your condition should worsen" then it's peace out, sucka. Also tell them if they have specific prefrences to inform the dispatcher when they call in, that way you aren't taking three crews OOS to service the ignorant fool.

 

[Ridryder911]

They want it "their" way find someone else. Sorry, this is NOT Burger King! I may NOT have a female on duty or a male in that area, they get what is offerred no matter what is based upon the gender, race, etc. Sorry, that is their biasis and hence that is their problem.

The same in the ER, we do NOT change staffing due to the gender. I am a male, which means I am assigned whomever hits the door.

Yes, attempt if possible, that is if and can with ease, but I don't make any special circumstance to meet their demands.

R/r 911

 

[mycrofft]

How about....

...if they want to order ala carte then they will wait for another unit to become available which can be a long time.

If you show a pattern of failing to provide service to a portion of the public due to religious ethical or cultural imperatives (I don't think "racist" counts), and you offer public service, you may be in violation of law.

What a great opportunity, open and run a service which offers "culturally sensitive" transport and maybe EMS! No, really, folks buy kosher food, folks buy Amish goods and Shaker goods, why not ....ah, how silly can I get?