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CONSENT IN EMERGENCY

CASES

REFUSAL TO GIVE CONSENT


DURING EMERGENCIES
Patient may be:
(A) Conscious
(B) Unconscious or incapacitated, and would

have someone to act on his behalf


()Includes the following situations:
(1) Refusal of a patient
(2) Refusal of the guardian
(3) Refusal followed by an emergency

1. REFUSAL OF THE PATIENT


SITUATION: Patient is conscious and has capacity to give

consent but vehemently refuses to give consent.


Example: Religious Beliefs Blood transfusions

SOLUTION: Physician must desist from doing something

to save the life of the patient. HOWEVER, he must exert


a certain degree of persuasion explain to the patient in
simple, adequate and understandable language the
inevitable consequences of the patients refusal.
WHY? Every human being if adult age and sound mind

has the right to determine what must be done to his


own body.

2. REFUSAL OF THE
GUARDIAN
SITUATION: Patient is a minor or not in a legal

capacity to give lawful consent. Parents or


persons in loco parentis (a responsible adult
acting in the place of a parent) refuse to give
consent.
SOLUTION: Physician must file an action in court
against such guardian to (a) give the physician
the necessary consent or (b) divest the guardian
of custody for unfitness or abandonment.
In case of abandonment, the court will appoint
the head of the social welfare institution to be
the guardian to act in the patients best interest.

3. REFUSAL FOLLOWED BY AN
EMERGENCY
SITUATION: Patients condition deteriorates

and he becomes unconscious in the later


course of disease or injury.
SOLUTION: Physician may obtain consent
from the guardian or relatives. In the
absence thereof, he can proceed with the
management which will redound to the
patients best interest.
If the treatment will cure the patient and he

is unreasonable to file suit against the


physician, the patient cannot recover more
than nominal damages. Physician will have
the defense of emergency.

EXTENSION OF OPERATIONS IN
CASES OF EMERGENCY
SITUATION: During an operation, an

accident occurs, or a condition discovered


requires immediate attention, which is not
covered by consent. Can the surgeon be
absolved from liability?
EARLIER DECISIONS SHOW RIGID
APPLICATION: NO. Physicians are LIABLE
whenever they go beyond what has been
consented to by the patient.
MODERN VIEW: YES. Emergency is given
a MORE LIBERAL INTERPRETATION to
include conditions not previously
characterized as life-saving.

WHY THE MORE LIBERAL


INTERPRETATION? (Steter and Moritz)
SELF RELIANCE: The surgeon is entitled to

follow sound medical practice and medical


opinion.
Subjecting a patient to subsequent

operations with its attendant risks and


costs merely for the purpose of obtaining
consent which the patient would give
anyway is unconscienable.

EXISTENCE OF AN EMERGENCY AND


WHEN SURGERY CANNOT BE EXTENDED
A SURGEON must lawfully perform an

extended operation as good surgery


demands in cases of emergency without
the consent of the patient.
Therefore, if during the application of an
operative procedure, a diseased condition
was found which does not require
immediate attention, the surgeon has no
right to extend the operation which may
require elective surgery.

WHO MAY ATTEND TO


EMERGENCY CASES?
I. ANY PERSON who thinks he is competent to help a sick and
injured person, in the absence of a physician.
II. MEDICAL STUDENTS AND REGISTERED NURSES
Medical students who have completed the first four years of the
medical course
2. Graduates of medicine
3. Registered nurses
1.

CONDITIONS:
4. With special authorization by the Secretary of Health
5. During an epidemic and nationwide emergency

III. PHYSICIANS: A Physician should always respond to any request


for his assistance in an emergency (Unless: there is risk to the
physicians life)

PHYSICIANS COMPENSATION FOR


EMERGENCY MEDICAL OR SURGICAL SERVICES
A Physician treats an injured or

unconscious patient under the Theory of


Implied Consent in physician-patient
contractual relationships.
The law implies an obligation of the patient
to pay the reasonable value of the
emergency service.
If there is no specified amount agreed
upon, Quantum Meruit (what one was
earned; what one deserves) shall apply.