MVA scenario

[rhan101277]

You arrive to a MVA. There are two vehicles involved and the accident looks minor. Two adults are in one vehicle and are fine with no obvious injuries. They refuse transport. The other vehicle's driver is 16, he has no complaints and no obvious injuries. A quick vitals check finds everything acceptable. He asks to leave. Do you let him go?

My answer is: Yes, although it is difficult for me to come to this. Because if a minor is with there father/mother and they say to take him you take him, if they say don't take him and he looks injured you can't. If he is by himself, but underage can he really sign a refusal form?

 

[reaper]

That is dependant on your state laws!

 

[Ridryder911]

That is dependant on your state laws!

Very true. In some states a "juvenile" can be considered an adult where as in some areas under the age of 18 is a minor (unless the other criteria ..i.e. pregnant, married, legally emancipated, etc).

In my state it is both. Yeah, confusing. Personally I much rather err on the patient side, if the patient does need to be evaluated. I attempt to make contact with the parents, or have the officer assume responsibility for the patient. Amazing when this occurs how much influence an officer can have in "suggesting" the patient to be evaluated.

If the patient parents can be reached, they can give verbal permission or denial. Be sure to have a witness listening and document .. whom, when and the discussion made.

R/r 911

 

[rhan101277]

Here is MS. the law is 18 to be an adult. Unless you are female, any female pregnant is considered an adult even if under 18. So best bet would be to try to convince him to go get checked out, even if he wants to leave.

 

[mycrofft]

Most common standard is cloudy at the edges.

"Children" or "minors" are often not considered competent but reasonable people in their teens seem to be able to withold or give consent anyway. In addition to getting a "refusal" signed and witnessed with name address and opertor number off the witneses driver's license (to keep them truthful) or officers badge number, make sure the pt is AOX3 and is knowlegeable about the nature of the supposed medical condition and the consequences of non-treatment or delayed treatment. Hysteria or altered mentation precludes informed consent and could arguably constitue implied consent.

As a side effect, in cases where the minor is allowed to give or withold consent, by the same token a parent's consent is sometimes not required. Civily you may spend years in court, but no battery charges... maybe.

 

[rhan101277]

Thanks for all the great comments. I feel this forum has got me somewhat ahead of the curve in class. There are such great discussions here.

 

[Jon]

First question - who called for the ambulance? Did the minor ever verbalize a complaint?
Why did you do an assessment? To some extent, if he has no complaints and doesn't want your services... that isn't a patient contact. In my mind, that is almost looking for trouble. Many calls we go on are from "cell phone Samaritans" and PD cancels us before we arrive because there aren't any injuries and no one wants our services.

In my area in PA, we will often do one of two things if we have a patient who is a minor who wants to refuse.
Choice one - call Mom/Dad - as long as they are OK with the refusal, if they can come to the scene to sign and take custody - that is great. If not, then we talk with them
by phone and get LEO's to wittiness it as well, then all sign refusal and we document the heck out of it.

Choice two - LEO's take responsibility for the youth and sign the refusal.

 

[mdtaylor]

He asks to leave.

In almost ANY state answering this would constitute either the giving of legal advice or acting in the capacity of a law enforcement officer.

Your answer should be a 'non answer.' Unless of course, you know your states laws very well....

 

[firecoins]

In almost ANY state answering this would constitute either the giving of legal advice or acting in the capacity of a law enforcement officer.

Your answer should be a 'non answer.' Unless of course, you know your states laws very well....

you seem to be giving legal advise. I am calling the police to have a swat team arrest you.

Let not go overboard here. We are talking about the law. Not giving legal advice. First amendment protects that.

In the world of cell phones, I would call up the parents. I would inform them of the situation and let them give verbal consent. Than document it.

 

[AnthonyM83]

While I would follow local law and protocol, I don't think one should even have to sign an AMA, since you're not giving the medical advice that he should go to the ER by ambulance...so he's not going against it...so there's nothing he needs to sign. But that's just me being idealistic.