Consent must be voluntary, competent and informed.  The law presumes that in an emergency persons want to receive treatment.  This presumption is rebutted if treatment is declined by a competent person, or if the person requiring treatment has an advance directive, such as a nonhospital DNR (do-not-resuscitate) order. In addition, if that person’s attorney in fact (e.g., someone who holds a durable power of attorney) is present, consent must be obtained. 

Ethics in Health Services Management

Kurt Darr, FACHE