Texas EMS Magazine, Volume 17, Number 3, May/June 1996 Page: 48
66 p. : col. ill.View a full description of this periodical.
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Jeff Rubin has been a
FF/EMT with Travis
County Fire Control/
ESD#4 since 1987 and
an EMT with Austin EMS
since 1993.AUSTIN
EMERG ENC
4 Irequested as well. Upon our arrival we
found an 81-year-old female, Dorothy
Jamar, with a minor complaint of
weakness, but alert and oriented. EMS
had been called by some close friends o
Ms. Jamar, without her knowledge. Her
friends informed us that she "had not
eating, and had lost a lot of weight." T
felt she needed to be evaluated in an
emergency room. Ms. Jamar adamantly
refused assessment, treatment and
transport. Although our further
assessment of Ms. Jamar suggested that
she might have been suffering from alt
mentation, she clearly was in sufficient
possession of her faculties to refuse our
services. Inspection of her residence
yielded the following conclusions: 1) she
had spent the previous night in her car
her garage, possibly because she hadn't
been able to get inside the house; 2) her
house was disorganized; 3) she appearTexas EMS Magazine May/June 1996
48
unable to provide for her own needs;
4) she possibly presented a hazard not
only to herself, but to her neighbors as
well, due to potential fire danger. As
Barb, along with the family friends, tried
to talk Ms. Jamar into voluntary
been transport, Ms. Jamar became
They progressively more insistent upon staying,
although she did permit limited
y assessment (blood sugar and vital signs,
which were all within normal limits).
At this point Michael Ramsey, one of
at four Austin police officers who had
erd responded to the call, entered the
t discussion and, playing off my partner,
began trying to persuade Ms. Jamar to
think about getting into the ambulance.
Officer Ramsey used gentle persuasion
, in and his attitude showed genuine concern
for Ms. Jamar's health and safety. After
r several attempts, we finally were able to
persuade Ms. Jamar to sit on the stretcher
and be taken to the Emergency Room at
Seton Hospital. Our on-scene time was
35 minutes, almost entirely spent trying
to talk our patient into transport.
Upon our arrival at Seton, Ms. Jamar
was reexamined. Tests over the next
several hours revealed possible malignant
masses in her abdomen and brain. More
significantly for her short-term health, she
was malnourished and dehydrated. After
two days of nourishment and hydration,
Ms. Jamar became fully alert and
comfortable. It was the consensus of Ms.
Jamar's friends, her neighbors, her
doctors, as well as my partner and me,
that Ms. Jamar needed to go to the
hospital. It was our opinion that Officer
Ramsey's efforts tipped the scales in favor
of her agreeing to transport.
This call raised some ethical and, I
suppose, legal, questions. At what point is
a patient no longer capable to make an
informed refusal? To what lengths can or
should we go to provide treatment andBarb Kniffin and Jeff Rubin were in the same EMT
class in 1987. Barb has been an EMT with Austin
EMS since 1989.
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Texas. Department of State Health Services. Texas EMS Magazine, Volume 17, Number 3, May/June 1996, periodical, May 1996; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1507922/m1/48/: accessed June 26, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.