When should you obtain patient consent in wilderness field care?

• A. Consent is never required in wilderness settings.
• B. Consent must be obtained from a legally authorized representative in all cases.
• C. Consent should be obtained when possible.
• D. Consent should be obtained only after evacuation.

Answer: (C)

Consent in wilderness field care centers on honoring the patient’s right to decide about treatment. Before any intervention, ask the patient for permission if they are oriented and able to decide. This respects autonomy, reduces ethical and legal risk, and often improves cooperation and outcomes. If they are unable to consent (unconscious, confused, intoxicated) and delaying care would worsen their condition, you proceed under implied consent to provide necessary, life-saving care. You would seek a legally authorized representative only if the patient cannot consent and a representative is available, but not in every case; and you should not wait to evacuate to begin treatment if you can safely treat in the field. Thus, consent should be obtained when possible.