Treatment based on transport decision

Treatment decisions should never be made solely based on the anticipated decision to transport (or not transport) a patient. Patients have autonomy and agency, and each component of care (assessment, treatment, transport) must be approached independently, with the patient's rights, needs, and values at the centre of decision-making. Consider your treat and discharge or palliative directives: these are perfect examples of scenarios where we can and should treat patients, but ultimately withhold transport.

Patients have the right to accept or decline any aspect of our care. This means a patient can consent to treatment while refusing transport, or agree to transport while declining a particular treatment. Autonomy and informed consent are foundational principles and rights in healthcare and paramedic practice. Even when a medication is indicated and clinically appropriate and recommended, its administration still requires clear, informed consent from the patient. Patients can also withdraw consent at any point along their journey.

When a patch is made, it can support clinical decision-making, but it does not override the principle of patient autonomy. OMC can help assess risk and offer guidance, but the final decision still rests with the patient, provided they have capacity.

In practice, this means we must clearly explain the rationale for any treatment, its risks and benefits, and involve the patient in those discussions. If the patient later refuses transport after a treatment has been given, that is their right, provided they are informed and capable of making that decision. For more information, please read a similar MedicASK question, published here.

Above all, we must maintain a patient-centred approach, communicating openly, documenting thoroughly, and ensuring the patient remains informed and empowered throughout their care journey.