When a patient refuses transport and is considered capable, which step should you take?

• A. Assess capacity, provide information about risks, document the refusal, and obtain a signed release if possible; arrange follow-up instructions.
• B. Ignore the refusal and proceed with transport.
• C. Call police to override the refusal.
• D. Leave the scene immediately.

Answer: (A)

When a patient is capable, the important idea is honoring autonomy while ensuring the decision is informed. The correct approach is to verify the patient’s capacity, explain the risks of not being transported, document the refusal in detail, and obtain a signed release if possible, plus provide clear follow-up instructions.

Capacity means the patient can understand the information, appreciate the consequences, reason about options, and communicate a choice. If all of that is present, you confirm they understand what declining transport means, including potential worsening symptoms and when to seek help, then document the conversation and the patient’s decision. A signed release isn’t always required, but it strengthens the documentation and can help protect both patient and provider. You also give practical follow-up guidance, such as when to call EMS again or seek care if symptoms change.

Why the other approaches don’t fit: ignoring the refusal and transporting disregards patient autonomy and can create legal and ethical problems. calling police to override the patient’s decision is not appropriate when the patient is clearly capable. leaving the scene immediately would be abandonment and unsafe for the patient.

In short, treat the capable patient’s refusal as valid, but ensure understanding, document it thoroughly, and arrange or communicate appropriate follow-up.