Despite this impressive research finding, legal aspects and specific techniques for safe, effective restraint application, receive inordinately brief coverage in all EMS training programs. Involuntary treatment of persons incompetent to refuse treatment. And, for all practical purposes, a person is considered to be competent until proven otherwise. The legal concept of competence can only be formally determined in a court of law.
Laws governing competence and the right to refuse medical treatment vary widely from state to state.
But, the determination of competence generally depends upon four observable abilities. The ability to communicate a choice. The ability to understand relevant information. The ability to appreciate the situation and its consequences. The ability to weigh the risks and benefits of options, and rationally process this information, before making a decision.