Medical Control Decisions: When Does a Neonate Become a Separate Patient?
Prehospital and Disaster Medicine · 2019-04-01 · Case report
Abstract
Patient refusal for care or transport is a common request to medical control physicians, and it is an especially challenging decision in the case of minors. Parents or guardians are able to refuse medical care for a minor if there is not an imminent threat of harm to the minor. However, if a minor patient is presumed to be in need of emergent medical care to prevent harm, medical personnel have the right to treat the minor, even if the parent or guardian objects. If the minor patient is a fetus or a neonate, it is not always clear when they are considered to be a separate patient. Apparently, there is no over-riding general rule or law and, consequently, Emergency Medical Services (EMS) protocols vary greatly from state to state. This case report describes one patient case that involved some of these unclear legal areas and how it fit with local EMS protocols. The legal question arose when a pregnant patient delivered her baby, but the umbilical cord was not cut. Are the mother's rights violated by cutting the umbilical cord if she objects to the procedure? How is the medical control physician to decide when to go beyond established EMS protocols to ensure that the safest and most ethical care is provided to a patient in the field? Does the care of the infant or the mother take precedence? Continued analyses of cases are required to ensure that protocols and guidelines are protecting both patients and providers.Venegas A, Ann Maggiore W, Wells R, Baker R, Watts S. Medical control decisions: when does a neonate become a separate patient? Prehosp Disaster Med. 2019;34(2):224-225.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Ethics · Medical direction & oversight · Neonates · Pregnant patients · Prehospital physicians
Related articles
- Transportation of Medical Staff by Helicopter to Manage a Concealed Delivery at Home. (Air Med J, 2023)
- Medical retrieval of pregnant women in labour: A scoping review. (Australas Emerg Care, 2023)
- [Prehospital obstetrical emergencies in a physician-staffed ground-based emergency service. A retrospective analysis over a 5-year period]. (Anaesthesist, 2009)
- Long-distance relay transportation of a patient with twin-twin transfusion syndrome requiring early delivery by Doctor-Helicopters. (Tokai J Exp Clin Med, 2010)
- When Every Minute Counts: Predicting Pre-Hospital Deliveries and Neonatal Risk in Emergency Medical Services Using Data-Driven Models. (J Clin Med, 2026)
- Obstetric characteristics and neonatal outcome of unplanned out-of-hospital term deliveries: a prospective, case-control study. (J Reprod Med, 2005)