Medical consent question.

NUTLEY BOY

This is a pure theoretical only.

Suppose the following ;

P is found unconscious on a street and is removed to hospital by ambulance.
P has no phone or other means of identification about his person.
Work up reveals the presence of a life threatening brain injury requiring immediate surgery as death will otherwise be likely.
P remains unconscious at all times.

Can the hospital and the doctors proceed legally to operate ?
Where do they stand in relation to the issue of consent ?

GM228

Consent is based around capacity and the right of autonomy, if they are unconscious they lack the capacity to exercise autonomy.

Even where there is an advance decision not to receive treatment it is not always recognised depending on the facts as the right itself is not absolute, where the medical staff do not reasonably know of any such decision they would not be liable.

Bikerman2019

As I understand, as a member of a voluntary first aid body, an unconsious person automatically can be given necessary urgent treatment on the good samaritan idea, unless they are able to say no.


If they DONT consent, while able to, then we cannot treat them.


I cannot say much more as I dont know more.

Dav010

I can’t give a legal answer, but from a medical ethics perspective, In Ireland there is generally no duty to intervene, but there are specific circumstances in which a duty to intervene and rescue have been imposed by the courts.

Where a ‘special relationship’ exists, such as between a physician and a patient when a patient is brought in unconscious to a Hospital, a duty to act is likely to be implied by the courts.
In other words, where there is a relationship of dependency, the ‘dominant’ party may have assumed a duty of care in respect of the ‘dependant’ party and a failure to act, and to act to a sufficient standard, might attract liability.

Peregrinus

NUTLEY BOY wrote: »

This is a pure theoretical only.

Suppose the following ;

P is found unconscious on a street and is removed to hospital by ambulance.
P has no phone or other means of identification about his person.
Work up reveals the presence of a life threatening brain injury requiring immediate surgery as death will otherwise be likely.
P remains unconscious at all times.

Can the hospital and the doctors proceed legally to operate ?
Where do they stand in relation to the issue of consent ?

In circumstances like this consent is inferred from the circumstances. The medics would certainly provide treatment, and would not be at any risk of professional discipline or legal sanction for having done so without the patient's explicit consent.

Bikerman2019

If I am driving down the road and (as has happened), I come across somebody who has been in a crash and is not conscious, I can and do apply treatment as a first responder.


If the person is awake and says dont touch me, then I cannot.


Years ago, before the current set up of firemen being paramedics, there was a case where DFB had an ambulance service alongside the HSE. At one incident, the casualty refused to allow the DFB to treat them, and the Health Board had to dispatch a qualified ambulance at the time.

UrbanVixen

Interesting discussion.

What exactly would be the hospital's duty of care - if any - in the unconscious scenario ?

Could this be one of those scenarios where if there is no duty of care owed you can effectively create one by intervening where there is no obligation to do so ?

Sparkey84

very interesting topic although from a legal perspective very easy. it is called implied consent.
one typical example of this when a nurse walks over to patient to do a blood pressure and they hold out their arm. the patient's consent was implied by the action of holding out the arm.
the other typical example is the unconscious patient. it is ok to assume they would want treatment.
Even if P was shouting loudly throughout the streets that he did not consent to treatment or transport the moment he went unconscious the paramedics could take him.