This lack of capacity may be temporary or permanent and may be due to a natural state, age, anxiety, illness, injury, drugs or sedation, intoxication, or other cause. An adult patient shall not be considered incapable to make a decision regarding proposed treatment based solely upon the fact of his or her refusal of medical care. The attending physician shall document the basis of such finding in the patient's chart. Alternate Sources of Consent for Incompetent Patients. Once the determination has been made that a patient lacks capacity to give informed consent, permission should be obtained in the following order.
Exceptions exist in an emergency.
The opinion of legal counsel may be sought if there are any questions regarding the scope of the document under consideration. Although the law does not specify an order of preference for substituted consent, care should be taken to contact the legal guardian, conservator, or custodian. If the nearest available person is contacted and refuses to consent, an attempt should be made to obtain consent from another person on the list above. If there is no time to seek a court order, and an emergency exists , follow the procedure in Section. When consent cannot be obtained through any other means, a court order can be obtained giving consent for treatment.