According to NREMT guidelines and standard EMS ethics, a competent adult patient has the legal right to refuse any portion of medical care, including spinal immobilization, as long as they demonstrate decision-making capacity. In this scenario, the patient is refusing one specific intervention (the cervical collar), not transportation or overall care. Therefore, EMS providers must respect the patient’s autonomy while continuing to act in the patient’s best interest.
Option A is correct because the appropriate action is to clearly document the patient’s informed refusal of the cervical collar and continue transport. Documentation should include the patient’s mental status, orientation, explanation of risks provided, the patient’s understanding of those risks, and the patient’s explicit refusal. This protects both the patient and the EMS provider legally and ethically.
Option B is incorrect because restraining a patient to force treatment constitutes assault and battery unless the patient lacks decision-making capacity or poses an immediate danger to themselves or others. There is no indication in the question that the patient is incompetent or combative.
Option C is incorrect because the patient has not refused all care—only spinal immobilization. Abandoning care by leaving the scene would violate EMS duty to act once patient contact has been established.
Option D is incorrect because withholding transport unless the patient complies is coercive and unethical. EMS providers must not threaten or pressure patients into accepting treatment.
In summary, NREMT emphasizes patient rights, informed consent, and thorough documentation. Transporting the patient while documenting refusal of immobilization is the safest, most professional, and legally sound course of action.
