Page 18 - PJ MED OPS Handbook 8th Ed

Refusal of Medical Care and/or Transport

In general, Active Duty military members may not refuse life-saving medical care. Mentally com-
petent adult civilians (including dependents, spouses and retired military members) may refuse
medical care, even if refusing medical care endangers their lives. PJs should make every effort to
ensure that patients refusing medical care are aware of the possible consequences of their actions.
The patient should be urged to seek other medical care as soon as possible.

• If the patient is unconscious, or unable to make a rational decision (secondary to head injury
or any other cause of altered mental status), the principle of Implied Consent assumes that a
normal, rational person would consent to life-saving medical treatment.
• If the patient is a minor or mentally incompetent adult, permission to treat must be obtained
from a parent or guardian before treatment can be rendered. If a life-threatening condition
exists, and the parent or guardian is unavailable for consent, treatment shall be rendered
under the principle of implied consent, as noted above.

• If an alert, oriented patient with normal mental status refuses medical care, then care cannot
be rendered. Medical control should be contacted (if possible) if such a situation occurs.
• If a patient refuses medical care the following statement must be written on the medical
treatment form and signed by the patient if possible.

I, THE UNDERSIGNED HAVE BEEN ADVISED THAT MEDICAL ASSISTANCE ON MY BEHALF IS
NECESSARY AND THAT REFUSAL OF SAID ASSISTANCE MAY RESULT IN DEATH, PERMANENT
INJURY OR IMPERIL MY HEALTH. I REFUSE TO ACCEPT TREATMENT AND ASSUME ALL RISK
AND CONSEQUENCES OF MY DECISION. I RELEASE THE UNITED STATES AIR FORCE AND THE
DEPARTMENT OF DEFENSE FROM ANY LIABILITY ARISING FROM MY REFUSAL TO ACCEPT
MEDICAL CARE.

NOTE: The statement must be signed and dated by the patient and countersigned by a wit-
ness. The medical record should completely document that the patient is awake, alert, ori-
ented and has normal mental status. If the patient refuses to sign the form, and still refuses
medical care, the patient’s refusal to sign should be documented and signed by the treating
PJ and preferably by at least one other witness.

16 n Pararescue Medical Operations Handbook / 8th Edition