goth idiots welcome

There are three forms of consent in EMS, informed, implied, and expressed. Informed is when we explain the procedure, and then they say yes. Expressed is when we say "Can I help you?", and then they say yes. Implied is when a patient is unable to consent (usually because they are unconscious), so we presume they would rather not die, and treat them anyway.

With minors, when their parents are there (or other adults with the legal ability to act as proxy for the parents) we go to the adult for consent, "Does your son need help?", "It looks like your granddaughter has a broken arm, we're going to need to splint it to keep it still on the way to the hospital, okay?" The parents can't refuse care if the kid's life is at risk, or if they're not stable (so no bleeding to death or nothing), but they can go "Actually, we'd rather take this sprained wrist to urgent care than the er please", and then not do either, and all we can do is report to cps if we feel suspicious.

If they're alone though, we treat them under implied consent, like the unconscious people, even if they're 17 and fully conversational and aware, they have no right to say no to anything we're doing unless they're emancipated, which is really hard to do (or if they've given birth and have custody of the baby). If they say "I don't want you to touch me, I just need a ride to the hospital", we still have to touch them (for vitals/any other treatment), without their consent. If they say "I know the risks of walking on a sprained ankle, but we can't afford a hospital bill right now. I'd rather go to my normal doctor", we still have to take them to the hospital, against their will.

i HATE self-censorship for a lot of reasons, but being in crisis work makes it even more frustrating. who are you censoring for? like i am being so fr, WHO are you censoring for? have you even thought it through? people who have been raped know that they have been raped. if someone attempts suicide or is grieving someone who did, saying "sewer slide" isn't going to protect them from any of the feelings. a murder victim's family isn't going to feel better bc you said "unalived" instead of murdered. if anything, it's just extremely invalidating and othering. it's saying "what happened to you is so bad that i won't even say the word," which is NOT trauma-informed care. you are not protecting survivors/victims when you self-censor. the ONLY things you protect when you self-censor are the puritanical ideologies that are being encouraged by rich fascists who want your money and obedience

Marina Abramović and Ulay, Rest Energy, 1980

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