Can we all agree on one thing? The BAC threshold of .08 is not a measure of sobriety in general terms. It is a measure of a person’s sobriety as it pertains to safely operating a motor vehicle. I would like to ask my colleagues who are turning patients away because they are blowing > .08 to please reconsider this practice. Denying patients care because their BAC is over the legal limit to operate a motor vehicle makes no sense.
There are better ways to determine if a patient is able to give consent that are likely being employed with every other emergency department patient: Can they ambulate without assistance? Are they A&Ox3? Can they participate in the exam process (by undressing themselves, following instructions, recounting their health and/or assault history)? Among the scant information available on the subject online, one particular sentence from a risk management site stuck in my brain: “The legal limit for driving in terms of blood alcohol has very little to do with the capacity to make informed decisions“. Case law on the issue of intoxication and consent appears to be centered on the issue of refusing care, not requesting it.
Please, do not take my word for it. I am not giving legal advice in this post, merely imploring people to make reasonable decisions supported by science and standards of practice that improve access to care for our patients. Give a call over to those nice lawyers in your risk management department and talk to them. And then follow their instructions. And also create a policy in your program that everyone will follow. I literally field a question on this topic at least once a month, from all over the country. This topic is single-handedly robbing me of my youth and beauty.
Thank you. That is all.
2 replies on “Sobriety and Medical Consent”
I believe there was a Medscape article addressing this same issue. Do you happen to know what it might be? I have searched their database but can’t seem to find it.
Alcohol and ability to consent for an exam but not consent to intercourse is such an issue in court.
Thank you.
Patti,
I absolutely agree this is an issue–as I explain it, we treat intoxicated patients all the time in the ER. There’s no such thing as being too intoxicated to ask for help. That’s a very different thing than being too intoxicated to consent to sex. Medscape may have addressed this issue, but the only one I know of is again in regards to *refusing* care: http://www.medscape.com/viewarticle/770719 Let me know if you need anything else.