First aid is a crucial aspect of emergency medical care. It can be everything from helping an unconscious person to putting a bandaid on a small wound.
As first aid is sometimes performed by members of the public, it raises the question:
Can a bystander administer assistance to someone in need without explicit consent for first aid from the patient? 
It’s a valid question. On one hand, lack of understanding or fear of legal repercussion may stop someone from responding. On the other, choosing not to act can potentially endanger someone’s life.
In this blog, we will delve into both the legal and ethical aspects surrounding patient consent in first aid and if you, as the first aider, need to obtain it before performing life-saving measures.
Understanding Consent
Consent in the medical context refers to the voluntary agreement of a patient to receive a particular treatment or procedure after being informed about the details, risks, benefits, and alternatives.
Different Types of Consent
According the the Canadian Medical Protective Association, there are several types of consent that may apply in different situations:
- Expressed Consent: This can be verbal or written and involves a clear and direct communication of agreement.
- Implied Consent: This occurs when a person’s actions indicate their agreement without express verbal or written consent. For example, a person extending their arm for a blood test is providing implied consent.
- Informed Consent: Consent that is given with full understanding of the risks, benefits, and alternatives.
- Parental or Legal Guardian Consent: In cases involving minors or individuals who cannot provide consent due to incapacity, a parent or legal guardian’s consent is required.
Legal Aspects of Consent for First Aid
The laws surrounding first aid and consent can vary widely among different jurisdictions.
For example, in Canada, the law requires that first aiders get permission from the patient (if possible) before administering first aid.
When is Consent for First Aid NOT Required?
Medical emergency response comes down to acting in the person’s best interest, and the need to help them can often override the need for explicit consent.
This generally occurs when immediate action is necessary to preserve life or prevent serious harm, and the person is unable to provide consent due to unconsciousness or incapacitation. The assumption in these cases is often that a reasonable person would consent to life-saving measures if they were able to do so.
In fact, Canadian law assumes the first aider has permission if:
- The patient is unresponsive
- The patient is a child without a caregiver
Good Samaritan Acts
Many jurisdictions, including many Canadian provinces, have enacted Good Samaritan laws to protect individuals who voluntarily offer assistance to those who are injured or in danger. These laws are designed to reduce bystanders’ hesitation to assist, fearing legal repercussions if they inadvertently cause harm.
Learn more about the Good Samaritan Act and why you shouldn’t be scared to use an AED.
Asking for Consent for First Aid as a Bystander
Asking for consent in an emergency requires both sensitivity and assertiveness. Here are some tips:
- Identify Yourself: State your name and if trained, state your level of training.
- Explain the Situation: Calmly explain what you observe and what assistance you plan to provide.
- Ask for Consent: Directly ask for consent to provide help and wait for a verbal or non-verbal agreement.
- Respect Refusals: If the individual refuses, respect their decision unless there are clear signs that immediate action is required to save their life. If the call has not yet been placed, immediately call 911 and state that the patient has refused providing consent.
Consent for first aid can become a complicated balance of legal requirements, ethical considerations, and the immediate need to provide assistance.
At the end of the day, however, protecting the patient should be at the forefront, especially if they are in a position where they cannot explicitly consent (i.e. they are unresponsive, incapacitated, etc.)
Education and awareness are central to promoting responsible first aid practices. Not only does first aid training provide deep insight into consent, but it also gives you the tools you need to respond appropriately in a medical emergency – and potentially save a life.
While you’re at it, grab our Onsite AED to use is an emergency – you can never be too careful!
