Say Leonid collapses on the sidewalk. 911 is called and he’s brought to an ER. He’s either unconscious or has an altered state of consciousness. Tests are ordered, perhaps he’s rushed to emergency surgery. He survives, but doesn’t have insurance and refuses to pay his bill. Now I know hospitals have ways to take patients who can’t pay into account, but is there any way the hospital could take him to court to recover the moner seeing as he never asked for or consented to treatment?
Leonid is liable, based on a theory of implied consent. Here’s a quick overview.
Yup. I think he’s liable for the cost of services received. The life or death emergency trumps his lack of consent if he’s not able to object to treatment. If he’s homeless, then serving him with process ain’t gonna be easy, and collecting a judgment would be almost impossible, but that doesn’t change his liability.
What Doctor Who said.
Depends on the jurisdiction, doesn’t it?
Change the situation slightly. Leonid is unconscious, but in his wallet is a piece of paper identifying Leonid as a member of a religion that does not believe in medical intervention.
Do the doctors ignore his wishes?
Assuming they do, what happens to liability for payment?
Or his wallet contains an explicit DNR request and the revive him.
I suspect that the doctors will do what’s necessary to stablize him and sort it out later. I doubt that payment is a concern in an ER, despite all the horror stories floating around.
Similar situation where doctors get a court to intervene in the case of a child. Do they bill the parents who refused the care in the first place? I doubt it.
or it turns out the wallet and the DNR/religious statement belong to his brother. Leonid would have wanted to be saved and so the doctors that acted on it need to make all Leonids family independently wealthy.
The burden of proof is on Leonid that he does not want what the majority of the population wants; that emergency services try to save his life.
It’s not so much an implied consent issue. That’s part of the law of informed consent, which is a tort concept. http://biotech.law.lsu.edu/books/aspen/Aspen-INFORMED.html
Instead it’s part of the doctrine of necessaries. You are liable for necessary items (food, medical care) which are provided to you in some cases. *E.g., * K.A.L. v. Southern Medical Business Services, http://www.birminghambar.org/data/SlipOpinions/CivApp/2011074_17.htm (Ala. Ct. Civ. App. 2003) (prisoner who attempted suicide was liable for necessary medical treatment despite lack of consent to treatment). In fact, minors are liable for necessaries; http://www.jud.state.ct.us/external/supapp/Cases/AROcr/CR267/267cr19.pdf (minors liable for necessaries); so are spouses:
http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=nc&vol=1996\supreme0209\&invol=forsyth
Ah, my bad. Correct you are Gfactor. Implied consent would go to whether the hospital/doctors are liable for battery, etc. Recovery of the costs of medical care would fall under a quasi-contract theory.
If Leonid is found down, the police have his wallet. To those caring for him in the ER he is John Doe #xxxx, until his identity is confirmed, or he wakes up and verifies his name.
If he then, insists he doesn’t want care, and he is not impaired, (drunk, stoned, head injured) he would be allowed to sign himself out AMA (Against Medical Advice). He’d still be liable for the care he’d already gotten.
Gfactor: So, implied consent would be what allows us to take an unconscious/altered patient to the hospital and the doctrine of necessaries is what makes the patient liable for payment. Is my understanding here correct?
As far as the wallet issues go, we don’t exactly spend a lot of time looking through people’s wallets, so it’s extremely likely that both a wallet DNR and a wallet religous affiliation card (or whatever) would not be found before the patient was transported to the hospital. As an aside, all the states I’m familiar with have provisions for a DNR bracelet or necklace. That would be binding.
St. Urho
Paramedic
That’s pretty much it, yeah. One is a defense to a lawsuit for damages (kidnapping, battery, lack of implied consent, for example), the other entitles you to get paid for your services.
Got it. Thanks!