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GUEST EDITORIAL 24 JUNE 2015 | EMSWORLD.com A patient with impaired decision-making capacity and a serious medical condition needs a capable person to start making decisions on their behalf. That may be the EMS provider or a family member in conjunction with the EMT or paramedic. This should never be seen as "kidnap- ping." While some patients are trans- ported over their objections, this is a medical intervention to go the hospital. Ransom demands aren't made, and there is no ill intent. In the case of the person stabbed in the abdomen, it is unlikely he has enough decision-making capacity to let him decline care. Conclusion In summary, I believe patients have a right to make informed decisions I don't nec- essarily agree with. As EMS providers, we have to be careful about thoroughly assessing decision-making capacity and mental status, following protocols for patients who refuse transport, and docu- menting every encounter. Many systems also mandate discussing such cases with online medical control. Savvy EMTs and paramedics develop methods for resolv- ing patients' concerns about being trans- ported. Sometimes it's as easy as making sure a pet will be cared for or a loved one is contacted. REFERENCES 1. Brock DW. The idea of shared decision making between physicians and patients. Kennedy Inst Ethics J, 1991; 1(1): 28–47. 2. Lo, B. Assessing decision-making capacity. J of Law Med & Ethics, 1990; 18(3): 193–201. 3. Jones RC, Holden T. A guide to assessing decision-making capacity. Cleve Clin J Med, 2004; 71(12): 971–5. I BELIEVE PATIENTS HAVE THE RIGHT TO MAKE INFORMED DECISIONS I DON'T NECESSARILY AGREE WITH. Visit us online and start your own leadership plan! www.ColumbiaSouthern.edu/EMSworld | 877.258.7153 Online Degrees. Afordable Tuition. Superior Service. For More Information Circle 23 on Reader Service Card ABOUT THE AUTHOR Thom Dunn, NRP, PhD, is an assistant professor of psychological sciences at the University of Northern Colorado. Additionally he is a clinical psychologist at Denver Health Medical Center. Thom has been involved in EMS for nearly 30 years and is a part-time paramedic field instructor for the Denver Health Medical Center Paramedic Division. Reach him at thomas.dunn@unco.edu.