ARGEO PAUL CELLUCCI

GOVERNOR

JANE SWIFT

LIEUTENANT GOVERNOR

WILLIAM D. O'LEARY

SECRETARY

HOWARD K. KOH, MD, MPH

COMMISSIONER

MEMORANDUM

TO: Licensed Ambulance Services, Regional Directors, EMCAB Members

FROM: Louise Goyette, Director, Office of Emergency Medical Services

RE: Guidelines on Out-of Hospital Treatment of Minors

DATE: August 21, 2000

The Office of Emergency Medical Services (OEMS) has been approached by several ambulance services seeking guidance on handling cases where minors refuse treatment and transport by EMS personnel responding to a call for emergency medical services. OEMS, in conjunction with the Legislative & Regulatory committee of EMCAB, representatives of the Massachusetts Police Chiefs Association, and the Department of Public Health’s Office of General Counsel, has developed the attached advisory in response to this need. OEMS recommends that each service consult with its legal counsel and use these guidelines to develop a written policy for how its staff are expected to handle cases involving minors. Once a policy has been developed, the service should provide opportunities for EMT staff to discuss the company policy and obtain clarification if needed. Cases involving minors, especially in cases where minors are refusing treatment and/or transport, call for EMTs and ambulance service supervisory staff to exercise discretion in determining whether an emergency exists and whether the doctrine of implied consent may be applied. Such judgments should be made in consultation with EMS supervisors, medical control physicians, and law enforcement officials. It is important that each ambulance service work closely with local public safety agencies in the development and implementation of its policy regarding this issue.

The Commonwealth of Massachusetts

Executive Office of Health and Human Services

Department of Public Health

Office of Emergency Medical Services

56 Roland Street, Suite 100

Boston , MA 02129-1235

(617) 284-8300