When “You Don’t Need to Go” Becomes “You’ve Been Served”: Avoiding Legal Liability for Provider-Initiated Refusals

EMS providers are highly trained and clinically skilled. But there is an emerging trend of lawsuits arising from EMS providers encouraging (sometimes coercing) patients to refuse transport. Disturbing videos on Ring and other surveillance cameras show providers actively telling patients not to go to the hospital but providing no alternatives or inappropriate advice. Providers must tread carefully when suggesting non-transport, ensure appropriate assessments, and ensure that the patient and/or family share the decision-making. Nick, an EMS Division Chief with over two decades of emergency response and quality assurance experience, and Samantha, an attorney for one of the largest hospital-based EMS systems in the Southeast, examine the clinical, legal, ethical and operational implications of provider-initiated refusals. Using actual incidents and reported legal cases, Nick and Samantha offer tips and tricks for responders to protect themselves and their services from legal liability in the event of a provider-initiated refusal.