I can’t find my data - I think its on a different machine. I only regularly measure the variability between the Dex and the fingerstick. Dex works as a nice tie breaker if your super concerned about it. Remember that this difference in readings in more significant below BG = 100 than it is above 100.
Where I live, medical protocol says that the ambulance can take you, against your will, to the hospital if BG < 79. So, running at a perfect 83 may put you at risk of ambulance transport (although, I doubt that they would do this unless you were unconscious). How does meter inaccuracy affect their determination of ‘driving with low blood sugar?’ Could they suspend your license if the medics read a 79? Actual range means BG could be low or could be perfect. ??? Not to become a diabetes lawyer, but its a curious situation.
Medical protocol is not the same as law. In most areas of the United States, it would take a Police Officer to take a conscious (and competent) adult anywhere in which they refuse to go. Trying to do otherwise would likely result in being at the bad end of a civil lawsuit.
This is actually backed up by the US Constituion per the Cruzan v. Director, Missouri Department of Health case in 1990. Competent adults have the right to refuse medical treatment per the Due Process Clause. Certainly this allows the argument to focus on whether the particular adult in question is “competent” at that moment in time or not. Having a BG of 75 absent any other symptoms would not likely be enough to satisfy this ruling from the US Supreme Court.
Well, yes, they have to get the cops - unless pt. is unconscious. And visa versa, the police would have to call the medics, unless they were a trooper/medic. It’s illegal to drive with low blood sugar. I have had cops ask me if my BG was OK, but I’ve never had anyone ask to see the reading on the machine. It’s an issue if the medics find you unconscious. For example, if your the faint type, and then you wake up. 79 - They take you to the hospital and they have the legal right to take you (typically), 80 - They have to find another reason to take you. Cops will back them whatever they decide - the medics are in charge of ‘medical’ judgment over the cops. The medics are like the judges. They get final say. A second example might be, you fall down and break your ankle and one of your friends makes a statement, like, “She’s a diabetic!” People often do this. Someone calls the medics. You say that you want to drive yourself to the hospital. BG = 70 --> You go by ambulance if they choose. 80 --> You make your own decisions.
I find that this has been my biggest issue with discrepancies between BG values. If I were going to carry a BG machine, in my ski pack, or in my car, for myself, I would carry a machine that tends to read higher values. I might carry a lower reading one for using on other people. If I wanted to cook the books in my favor by subtly manipulating data. I’ve never done that, the thought just now occurred to me.
The final say will come from the Judge. I guarantee if anybody tried to take me (an adult) against my will anywhere, I would vigorously protest. If anybody other than Police, I would physically resist and if Police then I would physically do nothing but verbally protest and would not provide consent at all. This would absolutely be followed with a lawsuit. Nobody has the right to decide what is in my best interest if I am conscious enough to be able to hold my end of a verbal argument.
I would win. The law is very clear. So I agree that at any particular moment in time, if Medics and Police act together, they are physically able to do something but that neither means it is right nor does it mean they will prevail in the ensuing aftermath.
The question of whether somebody is allowed to drive on the public roads is entirely a different argument. Public safety is always at risk when driving comes into play even before potential medical issues/complications are involved. There is no “right to drive”. Two different issues entirely.
I mean, medics are the judges, on the street, about deciding if you have to go to the hospital or not. Not in court. But if it goes to court, BG data collected, on scene, can be entered as evidence. BG data taken at the hospital cannot. It is protected by pt. confidentiality. Which, is why, if you are involved in a car accident, you might just take the financial hit and take the expensive ride to the hospital…if you think there’s a chance that your BG is < 79 (or whatever local protocols dictate). There are differences according to geography, but in general…
I imagine the hospital as ‘diabetic jail,’ so maybe I am more worried about this topic than others.
A study from Utah shows about 5% of Utah EMS incidents resulted in patient refusal of care. This is a large enough number that it is not only a subject of academic interest. This is practical.
All I can say is if a Medic is involved in forcing care or transportation on an unwilling adult who is competent this is Playing With Fire for the Medic. The law is against the Medic and eventually they will hit a patient who will fight back legally (later) through the court process. The US Supreme Court has already ruled on the issue.
Are you in Utah, Tim35? I’ve been taken MANY times against my will. However, sometimes I have been unconscious and then woke up in the hospital. The trouble can then become, getting out. I have an emergency plan set up for this case, but I would like to have a health care directive, in writing, that demands they free me as soon as I’m conscious! Maybe this is more of a concern for me due to epilepsy, but my epilepsy and diabetes get experientially interwoven, as well as legally. I very much like your perspective, it has just not been my experience.
If you have helpful hints, let me know.!
If I were conscious, and they took me, and my BG > 79, then I would feel like I was in a good position to sue and win. If < or = 79, I believe that I would loose in court. But, this discussed has opened up some legal doors, like the fact that you could cite the variability in BG readings (if you were right on the BG boundary.If this pops up as a problem, I’ll make @Tim35 testify as a ‘diabetes expert,’ for my defense. Could he do that? LOL. Could I call him a ‘diabetes advocate and expert.’
When I was called to jury duty, everybody sided with the chiropractor over the sports medicine neurologist (not me). So, Tim35 might win the case over the nurses.
Being taken to a Hospital while unconscious is entirely and very specifically within the bounds of the US Supreme Court decision. No question.
Your BG reading would not be relevant in a lawsuit. I would challenge you to find a single appeal which was upheld in which the BG was successfully used as evidence to transport, hold or provide any medical treatment to a competent adult against their will.
At ANY POINT IN TIME when you as an adult are competent (which by its nature demands consciousness at a minimum but may require more depending on the medical issue obvious case being seriously intoxicated but still conscious) then you have the right guaranteed by the US Constitution to refuse any and all medical treatment.
At the same time, there is absolutely NOTHING to stop a medical professional from trying to talk you into care. I would personally consider that their job and a moral imperative for them to follow their beliefs. If you then agree to the care then this is consent. However if you (as a competent adult) disagree and want to leave anyway - the doctor and hospital have zero legal basis for restraining you.
A Health Care Directive is used in different circumstances. If you are (at a given moment in time) competent and able to speak for yourself than a Health Care Directive does not add value.
Whether I am in Utah or not is irrelevant. I find many studies to be very helpful and illuminating which come from Utah. The University of Utah has numerous studies which I think are great additions to the collective knowledge. In particular I find their studies as related to driving and the highways to be well worth the time to read.
ahhhh, ‘competency’ is not defined as ‘consciousness.’ Re-read what I wrote…or at least give me time to edit. You are moving the conversation a bit faster than I can write and think, LOL. I’m trying communicate something that I have never tried to put into words before.
You are the one who mentioned being “unconscious”. I merely pointed out that being unconscious clearly means the person is not competent AT THAT MOMENT IN TIME to make their own decision. This part of the ruling is very black and white.
Yes, that’s where the boundary is comfortable for everyone. Otherwise, its a qualitative criteria that changes according to circumstances. Like, for instance BG = 79 is one criteria used to determine ‘competency.’ When I was a medic, I came down firm on what the patient wanted to do, but not everybody does. They did on my watch, because I’m a diabetic and I consider it pt advocacy to let them do what they want to do. But, not everybody is like that. People make different decisions in the same circumstances.
Could I, for instance, get a healthcare directive that demands I be freed from the hospital upon regaining consciousness, and that I assume all risks upon release? After a seizure, I like to sit outside in the sunshine in the grass and look at the sky. The sun feels different, and amazing, after a seizure. My brain is like an animals brain and I just want to sit outside in the grass. The hospital environment is too stressful to recover my wits comfortably.
Agreed. However this is subject to review and lawsuits later. Medical personnel would be well served to understand they can not enforce their own beliefs of proper quality of care upon a competent adult. Failure of such does get addressed through the legal system.
My point being that providing medical treatment against a person’s clearly stated directives simply because they have a BG of 75 while they have absolutely no other symptoms of being incompetent would fly in the face of the US Supreme Court ruling and would have the potential to end very badly for the particular medical person involved.
I encountered a related situation recently, with an elderly neighbor. I was walking down my street and saw ambulance pull away from her home. 2 minutes later, the ambulance returned, went into the house for 2 minutes and left again.
So I called her. She said she had some chest and stomach pain and called them. They checked her out and recommended she go in for more tests. She also had previous digestion issues with similar symptoms and had seen her doctor.
Her chest pain had subsided, that led to her refusal, so they required that she sign a form for that. So then they left, which is what I saw. They came back as they realised they had given her the wrong form to sign. Who was not competent then ?
The medical profession is so arrogant that it thinks it is above the law. Doctors and support staff seem incapable of understanding that medical treatment applied without the explicit or implicit consent of the patient is battery, and can result in a criminal charge or a suit for an intentional tort. At a dialysis center once I saw a patient being tortured with the pencil-thick, steel needles required for dialysis access, being plunged into the vein and artery anastomis in his arm. He was screaming and saying, “Stop! stop! It isn’t worth it!” but the nurses persisted in what they were doing. The nurses had no idea they were committing a criminal and civil wrong, and could have been sued. The man never came back.
quote from above:
“The medical profession is so arrogant that it thinks it is above the law. Doctors and support staff seem incapable of understanding that medical treatment applied without the explicit or implicit consent of the patient is battery, and can result in a criminal charge or a suit for an intentional tort.” I believe it is arrogant for anyone to say that all medical professions believe they are above the law which isn’t the case at all. I am a medical professional of 40 years and I nor anyone I’ve worked with have ever treated anyone against their will, other than unconscious, drunk, or mental unstable persons that were unable to give consent and needing emergency treatment.
It gets tricky, Tim35. Your a man, so you get bullied less about your ‘safety’ and such. Plus, sometimes they take refusal of care as a sign of illness. Then your f’ed. Although, I think that’s uncommon. I’m real touchy about IV’s because of my diabetes diagnosis, it’s been suggested that I have some mild to moderate stress reactions to them. Even on a good day, I might freak out and panic. In the hospital, I can’t say that I don’t need or want a saline IV. I have physically pulled them out, over and over again. That doesn’t mean they don’t just put them right back in. I don’t get to choose my treatment. Its all protocol.
I disagree this is a gender issue. I know just as many women who refuse to get pushed around as men.
I could care less whether somebody takes anything as a sign of whatever. That is their problem - not my problem.
Somebody ORDERS me to do something - they got a fight on their hands real quick (unless it is a Police Officer).
Somebody REQUESTS me to do something - different situation entirely. In which case I may or may not comply but it will be my choice and it would be done nicely.
You may not get to CHOOSE your treatment but you absolutely have a US Constitutional Guaranteed Right to REFUSE any treatment. You can ABSOLUTELY refuse a saline IV. 100% - This is the point I am trying to make. Within the United States, you have the Constitutionally Guaranteed Right to refuse ANY medical treatment at all. You could be 3 minutes from imminent death without that Saline IV (magic saline) but if you clearly state you refuse treatment, it would be assault and battery for any medical professional to save your life by administering that IV against your consent.
If such a doctor were to do that and you were to press charges, they would never practice medicine again in their life and quite likely would serve jail time.
Whether you accept and/or stand up for your rights is always an individual decision.
