What should EMS do if medical control directs differently than the health care agent's instructions?

• A. Follow medical control
• B. Follow the agent's instructions
• C. Seek a court order
• D. Pause treatment and consult hospital administration

Answer: (D)

When there is a conflict between a health care agent’s instructions and what medical control is directing, the priority is to protect the patient's legally expressed wishes while getting proper authorization to act. The health care agent’s directives are legal proxies for the patient’s preferences, but EMS also must work within clinical commands from medical control. Because these can diverge, the appropriate course is to pause treatment and escalate the situation to hospital administration (or the on-call medical control physician) to interpret the directives, confirm which instruction should guide care, and determine the proper next steps. This approach prevents acting on potentially conflicting guidance and ensures the patient’s wishes are respected, within legal and policy frameworks. In urgent cases, this escalation should be documented and pursued promptly; if needed, a court order can be sought, but the immediate step is to pause and obtain clarification from the proper authority.