DescriptionMy colleague and I received an emergency call following reports of a woman on the ground. Once there, an intoxicated man said his wife was under investigation for “passing out episodes.” She was lying on her back on the kitchen floor and unresponsive to AVPU. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then came to and said, "Oh, it happened again, didn't it?" I removed the airway and asked my colleague to complete the baseline observations and ECG which were all within normal range. During questioning, my patient stated that she did not want to go to the hospital. However, every time my patient stood up, she collapsed and we had to intervene to protect her safety and dignity, while trying to understand what was happening. During episodes of unresponsiveness, we brought the patient back to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and outlined my concerns. The patient's drunken husband then took his wife home. My concerns with this work were about the capacity of the patient. My feelings. I wrongly assumed that we were treating just another alcohol poisoning patient, so typical of a Saturday. night service. When I arrived, I had considered the safety of the premises due to the behavior of the drunk man who shouted at me: “Where have you been? I felt like he was testing my communication skills with his aggressive behavior, I attributed this to the amount of alcohol he had consumed. This proved frustrating at times, but I knew I had to be diplomatic because it could have made the situation worse. His body language showed he didn't have... middle of paper... skill. Available: http://www.hpc-uk.org/assets/documents/1000051CStandards_of_Proficiency_Paramedics.pdf. Last accessed October 22, 2012. http://www.direct.gov.uk/prod_consum_dg/groups/dg_digitalassets/@dg/@en/@disabled/documents/digitalasset/dg_186484.pdf. Last accessed October 13, 2012. NHS CHOICES INFORMATION. (06/01/2011). DO I HAVE THE RIGHT TO REFUSE TREATMENT? Available: http://www.nhs.uk/chq/Pages/899.aspx?CategoryID=68&SubCategoryID=156. Last accessed October 13, 2012. NHS Scotland. (). Public (with a duty of care). Available: http://www.advancedpractice.scot.nhs.uk/legal-and-ethics-guidance/accountability/public-(owing-a-duty-of-care).aspx. Last accessed October 12, 2012. Katharine Evans, James Warner, Elizabeth Jackson. (2007). What do emergency health workers know about capacity and consent?.Emergency Medical Journal. 24 (6), 391-393.