What Do You Do When You Don't Get Consent From a Conscious Person?

When a conscious person does not give consent, especially in a situation where they might need assistance, the most critical step is to respect their decision and avoid forcing help upon them.

The Foundation of Consent

Consent is a fundamental principle that upholds an individual's autonomy and right to self-determination. In any situation where you intend to provide aid, especially medical first aid, obtaining clear and voluntary consent from a conscious and competent adult is paramount. Proceeding without it can lead to serious legal repercussions, such as charges of assault or battery.

Understanding Refusal of Consent

A conscious, capable adult has the legal and ethical right to refuse assistance, even if their decision appears to be against their own best interest or could lead to negative health outcomes. Reasons for refusal can vary widely, including:

• Fear or anxiety
• Cultural or religious beliefs
• Mistrust of strangers or medical professionals
• Desire for privacy
• Perceived lack of need for help
• Simply wanting to be left alone

Regardless of the reason, their refusal must be respected.

Immediate Steps When Consent is Refused (Medical Context)

If a conscious person refuses consent for first aid or medical assistance, it is crucial to prioritize their autonomy while ensuring their safety is still assessed by professionals.

1. Do Not Proceed Without Consent: Under no circumstances should you provide medical aid, touch the person, or move them against their explicit wishes. Doing so can be considered battery or assault.
2. Call Emergency Services: If they refuse consent, call 911 (or your local emergency number) immediately and wait for emergency medical services to arrive. This action is crucial because it allows trained professionals to:
   • Assess the situation and the person's actual capacity to make an informed decision.
   • Determine if their refusal is due to an underlying condition (e.g., head injury, intoxication, or altered mental status) that might impair their judgment.
   • Offer appropriate assistance without violating their rights, using their expertise to navigate the situation.
3. Stay with the Person (If Safe): Remain nearby, at a safe distance, to observe their condition without pressuring them. Your presence can be valuable for relaying information to emergency responders.
4. Communicate Calmly: Reiterate your offer to help, respectfully acknowledge their decision, and inform them that professional help is on the way. Maintain a calm and non-confrontational demeanor.

Special Considerations

While the primary rule is to respect refusal, there are nuances:

Implied Consent

Implied consent is typically applicable only in situations where a person is unconscious, incapacitated, or a minor whose legal guardian is not present, and they are facing a life-threatening emergency. In such cases, it is assumed they would want help. However, this does not apply to a conscious, competent adult who actively refuses aid.

Capacity to Consent

A person's ability to refuse consent hinges on their "capacity" to make an informed decision. Emergency medical services are trained to assess if a person is truly capable of understanding their situation and the consequences of their refusal. Factors like severe intoxication, head trauma, or altered mental status might mean a person is "conscious" but lacks the legal capacity to give or refuse consent. In these instances, EMS professionals may be able to provide care based on a presumed emergency.

Summary of Actions

Ultimately, balancing compassion with legal and ethical boundaries is key. Your role is to offer help, understand the limits of your intervention, and ensure that professional assistance can be provided when appropriate and legally permissible.