Refusal of medical assistance

Refusal of Medical Assistance (RMA) is a term used in emergency medical services (EMS) to describe situations where a patient declines some or all medical treatment in the pre-hospital setting, such as during an ambulance response. In some parts of the United States, it is known as “patient refusal”, Refusal of Medical Aid (RMA), or Patient-Initiated Refusal (PIR).

The concept of RMA is specific to EMS and involves patients choosing not to receive care during an ambulance or emergency medical response. It is part of a broader phenomenon of patients refusing, delaying, or limiting medical treatments, which can also occur in other medical settings, such as hospitals or clinics. In some systems in the United States, pre-hospital refusal of medical assistance rates as high as 26% have been reported.