Should we let someone die who is unwilling (but otherwise capable) of doing what is needed to stay alive?

@freemo That’s a really interesting question! Putting my EMT hat on, if they’re competent they get to refuse an intervention but in practice those are hard calls.

More generally it kind of depends on other factors. For example, do you let someone ignore a mandatory evacuation knowing they may want to be rescued later at greater risk to all concerned?

It’s a thought provoking question. I’d lean towards answering “Yes” in the abstract and mostly in practice but I’m willing to believe there are circumstances where I’d be open to “No” and I can’t come up with a consistent limiting principle.

@Gbudd It certainly isnt an easy question… I will have to give my response to you some thought.


@freemo I should clarify a bit too.

When I’m out as an EMT it’s a relatively bright line. If they’re competent (alert and oriented, not a threat to themselves or others, over 18) they get to refuse medical attention. We might try to convince them but at the end of the day they get to choose.

There are calls where that feels crappy but at least we have a decision making framework to fall back on.

@Gbudd @freemo I’m confused by the “not a threat to themselves” part. I can’t see a way of interpreting that that doesn’t make them one in such situations.

@robryk @freemo I should have been a bit clearer. In this specific context (it might be different in other states) we can involuntarily transport someone who has explicitly expressed suicidal thoughts or acts.

It’s not the same case as “I think they’ve got a fatal condition but they don’t want to go to the hospital” though I guess it’s arguably a legal rather than moral distinction. In the EMT framework it’s just presumed that if you want to actively end your life that you’re not mentally competent.

@Gbudd @freemo

Ah, you mean they intend to be a danger to themselves, right?

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