EMS for mentally ill suicide/burn victim

[Educa]

I'm a Canadian educator tasked with the challenge of teaching English for medical purposes to a group of Japanese dermatologists here in Japan. During our session last week, I was asked a difficult question that I haven't been able to answer and I hope to get feedback from your experts. Here's the case. There was a schizophrenia patient who went to a gas station in a remote area in Japan. He set himself on fire and the staff immediately called EMS who responded swiftly to put the fire out. The patient suffered burns to about 95% of his body and the prospect for survival was very slim. When asked if they wanted to have the patient transported (very expensively) to a major facility far away for treatment, the family refused and the patient died.
The doctor in my class wants to know what would've happened in Canada and other countries.

Would the patient have been transported considering the high costs and the low probability of survival?

[Janmedic]

In norway we would have the patient transportet to trauma team in the hospital
FREE. and i guess that type of casualty would have ended up on Haukeland university hospital who are the experst in norway on treating burns.

in norway it doesent cost anything to call out EMS og any cind of transport costs.

[jvdelgado]

Same in Portugal! EMS, as well as inter-hospital transports, are free of charge no matter how expensive they are...

best regards
João Delgado

[triemal04]

In the US it woud really depend. If the family was unable to be found in a timely manner (and by timely I mean the amount of time it would take to get a helicopter to the initial hospital) then the pt would have gone. If they got there first...it's possible that he would have stayed. Although if it was clear that the decision was being made based on the cost only, I'm guessing a lot of doc's would have a problem with that and send him. If it was more that the chances for survival were extremely low, then I don't think it would be as much of a problem.

Really there isn't going to be a set answer, and a doc is better suited to answer the question. Far as prehospital goes, he would have gone, and if at all possible he would have gone directly from the field to the burn center.

[medic27205]

We would have flown the patient to the nearest trauma/burn center which is about 45 minute drive from our area. The family really has no say so... although we consider their imput. If the patient is unable to tell you where they would like to go or what treatment they would like to recieve, we treat those patients under "implied consent". That is to say it is "implied" that the patient would want the best medical treatement available for the condition.