Medical Consent for First Aid and CPR

There's an assumption that everyone who needs help wants it, but that's not always true. In order to care for someone in need, you must have their permission. In the medical field, permission is called consent, and it comes in two forms: expressed or implied.

Midsection Of Man Resuscitating Friend Lying On Road
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Expressed (Verbal) Consent

Expressed consent means a person understands your questions and gives you permission to give care. The victim must be able to clearly communicate his or her wishes for expressed consent to count. Sometimes expressed consent is given non-verbally via a gesture, for instance, if a person nods his head when asked a question.

Implied Consent

Implied consent is consent that's not expressly granted. It usually happens when you're unable to communicate with the victim. Most commonly, this is because he or she is unconscious.

Who Can Express Consent?

Expressed consent must come from adults who are not impaired. Don't touch or give care to a conscious person who refuses it. Touching someone without his or her consent can be assault or even battery. This is especially true if a victim has expressly forbidden you from touching him or her. If the person refuses care or withdraws consent at any time, step back and call for more advanced medical personnel. Don't get hurt trying to give someone help they don't want.

If the person is under 18, you must obtain consent from the parent or guardian if he or she is present. If they refuse consent, call 911 and wait for emergency medical services to arrive.

Intoxicated, developmentally disabled, confused, or underaged victims unaccompanied by an adult are considered to have implied their consent. The assumption is that the victims or their legal guardians would ask for help if they were able to do so.

When in Doubt, Assume You Have Consent

Safety is always paramount, so any time you're unsure of a victim's wishes, it's important to help. For the first aid provider, consent is not nearly as important as it is for an emergency medical service professional. Don't let the sometimes confusing issue of consent prevent you from helping others in need.

1 Source
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  1. Bester J, Kodish E. Cardiopulmonary resuscitation, informed consent, and rescue: what provides moral justification for the provision of cpr? J Clin Ethics. 2019;30(1):67-73. PMID: 30896446

Additional Reading
  • American Red Cross. Consent.

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.