Because there were cases where a paramedic took a refusal, and the patient later sued the paramedic and his employer for not recognizing the fact that the patient had a head injury and thus was incapable of comprehending the ramifications of refusing.
Sort of like the people who sue the bar for allowing them to get drunk. Like it or not, the law is what it is. If I document the medical reasons why I feel you are not capable, then there you go.
If you would like to read the general guidelines,
here they are.
The point is that all of you are assuming that paramedics are out there just chucking people into the hospital willy-nilly. I get paid the same whether I take you in or not. This is not some power trip, but an honest treatment that favors the condition of my patient.
This has exactly NOTHING to do with arrest, and everything to do with your inability to refuse. Sort of the same concept like: A woman with mental retardation cannot consent to sexual contact. Why? Because she does not understand what that consent means. Same thing here. This is not an arrest, but an attempt to get you the medical care that the law assumes you would want if you had the mental capacity to decide for yourself.
Implied consent states that a person who is incapable of making a decision is assumed to consent. Altered mental states are under the same umbrella. Note that Tenn law (along with other states) says that a COMPETENT adult may refuse care. If the paramedic can document that in his best medical judgment you were not competent, he must assume that you would consent, and may use reasonable force to take you to the hospital. If his report in any way indicates that he knew r should have known that you were incompetent to refuse, and he allows you to refuse, he is guilty of abandonment and is open to liability.
The law is what it is. Are there medics who will abuse it? Of course there are, but that does not erase the validity of the law for the rest of us. Just as you cannot blame one gun owner for the illegal and immoral actions of another, the same is true of medics. The leading symptom of serious head injury is altered mental status.
Real life example: Just two days ago, there was a young man who slid a motorcycle under a car. No helmet. He had all of the skin avulsed on his hand all the way down to the bone. He had road rash all over his back, and blood was coming out of his right ear. He said he wasn't hurt, and did not want to go to the hospital. He asked me if he could call his wife. We helped him find his cell phone, and he called her. Then we tried to convince him to agree to be transported. He refused. He then asked if he could call his wife. WE let him call her again. We continued our evaluation, and he asked to call his wife. We told him that he already had- twice. He said he didn't remember doing that, and he wanted to go home. I then told him that in my opinion, he was not competent to refuse, and we put him on a backboard with a cervical collar, and he resisted, so we restrained him. He then asked us if he could call his wife. We flew him to the trauma center for a trauma evaluation. If he did not remember calling his wife, how could he possibly understand an important medical decision?
Are you folks still insisting that paramedics should be permitted to accept refusals from such a patient? If you are, I have no problem with that, but you need to lobby your state legislature to change the law and make me immune from liability for doing so.
