Professionalism in Pre-Hospital Emergency Care: A Case Study of Care Refusal
Keywords:
Professionalism, Emergency Medical Services, Ethics, Case StudyAbstract
Introduction: Emergency Medical Services (EMS) frequently confront intricate circumstances necessitating ethical deliberation. In dangerous and unpredictable care situations, EMS professionals often face ethical challenges, such as patients' right to refuse treatment. In this study, we evaluate an ethical case study of a patient refusing health care.
Case presentation: In this case, a 40-year-old man, an avid athlete with no prior health issues, suddenly experienced severe chest and epigastric pain while at home. Despite a brief relief from resting, the symptoms recurred at 1 a.m. The distressed patient dialed emergency services, but after the EMS team evaluation, he adamantly resisted being transferred to the hospital. Clearly expressing his refusal, he insisted he would sign any necessary documents but was determined not to be transported to the hospital. After talking to the patient, the EMS team realized that he was under emotional stress due to a family dispute. The team managed to convince the patient to take him to the hospital by explaining his condition and getting his consent. In-hospital assessments revealed a real heart attack.
Conclusion: The case raises several ethical challenges, including respect for patient autonomy, decision-making capacity, determination of emergencies, and providing information to the patient. In cases where the patient refuses treatment, the EMS team must first assess the patient's condition and capacity to make decisions. If the patient's condition is serious, the team should take measures to protect the patient's life even if the patient refuses treatment.
Declarations
Ethics approval and consent to participate: this report was approved by the Institutional Review Board of this university with a code of IR.JUMS.REC.1402.105
Consent for publication: Not applicable.
Availability of data and materials: The datasets used and analyzed during the current study are available from the corresponding author upon reasonable request.
Competing interests: The authors declare no competing interests
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions: All authors have written and revised the manuscript. All authors read and approved the final manuscript.
Acknowledgments: The research team would like to present the sincerest thanks and appreciation to all emergency personnel (affiliated with Jahrom University of Medical Sciences) who participated in this study.
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