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01/2010

Sure. Verbal consents are allowed. Also, people come into the ED unresponsive all the time. We don't wait for them to wake up and sign a consent before we assess and treat them. For people that are awake it depends on the situation. We have people every day that refuse to be seen and are held against their wishes. If someone is not oriented, or is considered at risk for hurting themself or others, they may be held against their will. Opening your mouth and saying "I'm going to hurt myself" because you're fighting with someone may land you in handcuffs, sitting in the ED all night. And you will be billed for the visit and the ambulance ride even if you refused.

If there is no emergent condition, no body should do any procedure with out a signed consent, although the patient can give verbal consent. As far as normal people, if an emergent condition exist, the practitioner would have to balance the risk of liability from doing a procedure without a consent against the liability of doing nothing to treat the problem. Sometimes they do nothing and wait for the patient to change their mind or become unresponsive. Once the person is unresponsive, they are assumed to consent to reasonable treatment. If the person is cooperative with the procedure, but doesn't want to sign the consent the practitioner may or may not procede.

I once had a guy with a deep cut on his arm with arterial bleeding. He was a knucklehead, and refused to give his name, or sign a consent for treatment. The MD stopped the bleeding and closed the wound, and had the police called, who waited outside the room until the procedure was over. As soon as the MD walked out, the police walked in. The patient didn't want to give his name because he had an outstanding felony warrant. If he would have just given his name and acted normal, no one would have called the police, and he could have walked away. The police were called because without giving his name he was essentially stealing, receiving service, but not agreeing to pay. The MD treated the emergent condition so he couldn't be sued. Good guys win, bad guy goes to jail. It's always a bad idea to be a knucklehead in the ED.

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Q: Can a person still be treated if they dont sign a informed consent?
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