In all situations, however, medical necessity takes precedence. Therefore, if the patient is incapable of giving that consent because he or she is comatose or a minor or in some way disabled, then you can go ahead and provide the level of care that is necessary in order to maintain life and health. Mr. Dunn said informed consent can be an issue for residents working in emergency rooms and ambulatory clinics. For example, intoxicated patients who refuse treatment present a problem. Mr. Dunn said such patients can be treated because they are incompetent to make their own medical decisions and medical necessity takes precedence.
Competent patients are free to refuse care, and some do so based on religious beliefs.
But Mr. Dunn noted that while the law protects patients' freedom of religion by permitting them to deny care for themselves, this protection is not generally extended to their children. So if you have an adult saying that this child shares my religious beliefs and therefore doesn't get blood derivatives, you can go ahead and treat. Most informed consent laws require physicians to tell patients whatever an ordinary and reasonable physician would disclose in similar circumstances. But a growing number of states are changing the law to require that physicians disclose what an ordinary and reasonable patient would want to know in order to make an informed choice. Know your state's law.