What happens when a patient's decision-making capacity is deemed impaired?

• A. The patient is considered medically incapacitated and should be transported to the hospital.
• B. The patient can sign for discharge.
• C. The patient can refuse care.
• D. The patient should be left at scene.

Answer: (A)

When decision-making capacity is impaired, the patient cannot understand or communicate a valid treatment decision. In EMS, that means they are considered medically incapacitated, and emergency care is provided under implied consent with the goal of stabilizing and transporting the patient to the hospital for evaluation and definitive treatment. Refusals or discharges require capacity, so they aren’t valid if capacity is lacking, and leaving the scene without arranging appropriate care would be unsafe. If capacity is later regained, reassess and obtain proper consent or involve a surrogate decision-maker.