[3] The concept of RMA is specific to EMS and involves patients choosing not to receive care during an ambulance or emergency medical response.
[4] In some systems in the United States, pre-hospital refusal of medical assistance rates as high as 26% have been reported.
However, in cases where it is apparent that transport is unnecessary, emergency medical services (EMS) personnel may informally guide the patient toward signing an RMA form.
For instance, an injured but frightened child might be better comforted and transported to a hospital or doctor’s office by a parent instead of an ambulance crew.
This action, which involves essentially detaining the individual and releasing them to the EMS agency for medical evaluation, is a measure that should only be taken in extreme circumstances.
Patients who are intoxicated or otherwise incapable of understanding the implications of their refusal, such as those with cognitive impairments, cannot legally provide informed consent.
In these circumstances, the EMS crew may choose to wait for a parent or legal guardian, who has the authority to make medical decisions on behalf of the child.