patient consent

[William Wingfield <will@willwingfield.com>]

I believe any court would agree that you followed the "standard of 
care" currently provided across the nation.  Your patient had an 
altered LOC thereby falling into the standards associated with 
implied consent.  You must do what you believe is in the best 
interest of the patient.  As others have previously stated, without 
solid documentation of a POA and speaking directly with them they 
really "have no case".  Having said that, it is interesting to note 
that most facilities and physicians will turn to the closest next of 
kin available when critical decisions need to be made, assuming the 
patient is obtunded/incompetent at that time, regardless of the lack 
of documentation.  I.e.-  they will turn to the wife for directions 
when the husband is at the point of pull the plug or not.  No 
documentation is required.  This contradicts standard practices of 
EMS personnel in the field, even though they are "physician 
delegates".  You would backhand your partner if they asked the wife 
on the scene of a man coding, "Well mam, he's dying.  You want us to 
resuscitate or not?"  We generally "don't care" what the spouse 
thinks, unless there's a POA presented, "they have no say".   
Interesting......

Will Wingfield
Flight Paramedic
AeroCare

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