A patient who is not competent or has an altered mental state can legally refuse care.

• A. True
• B. False
• C. Not sure
• D. Depends on jurisdiction

Answer: (B)

Capacity and consent drive this principle. A patient who is not competent or whose mental status is altered generally cannot give legally valid informed consent. In urgent EMS situations, you rely on implied consent to provide life-saving care when there’s no capable person to consent. If a legally authorized representative or surrogate is available, obtain their consent. If the patient later regains capacity, explain what was done and obtain continued consent for further care. Capacity is decision-specific and can change, so assess the patient’s ability to understand and decide at the moment, and document your actions and rationale.