Author Site Reviewresults

G.3.22 Service Refusal


Paramedic Services Effective Date: April 30, 2022
Topic: Operations Directives Replaces: April 30, 2019
Subject: Service Refusal Policy No. G.3.22.



To ensure Paramedic Services personnel are aware of their responsibility to make every reasonable effort to facilitate treatment and transportation of patients, and to ensure that the Standard is met when processing the refusal of care.

  • Paramedics
  • Paramedic Superintendents


Where any patient refuses care, or refuses transportation following provision of care by Manitoulin-Sudbury DSB Paramedic Services, the Aid to Capacity section of the ePCR shall be completed, confirming the ability of the patient to fully understand their decision to refuse care/transportation. Age is not a limiting factor when determining a patient’s capacity to understand their decision regarding care and transportation. 

If any patient has refused transportation to a medical facility, Paramedics shall endeavour to ensure the patient is left with a responsible person, and that direction is provided should the patient change their position on transportation.

Where the Aid to Capacity has been completed, the Refusal of Service section of the ePCR shall be completed and signed by the patient/substitute decision maker and a witness where available. Additionally, all attending Paramedics shall sign the ePCR. 

Paramedic shall detail the rationale for the refusal of specific care, or transportation in the remarks section of the ePCR.

Where any patient does not successfully complete the Aid to Capacity, or where Paramedics reasonably believe the patient condition will deteriorate, personnel may access Police Services, or the Base Hospital Physician. In such instances, paramedics shall complete and submit an Incident Report. 

Refer to the ACR Completion Manual for more information.


Ministry of Health, Emergency Services Branch, Documentation Standards