Consent means permission for something to happen or agreement to do something.

Consent in three parts

Conscious Casualty

If the casualty is concious you will need to gain their permission to administer first aid

Unconcious Casualty

If the casualty is unconscious then consent is implied until they regain consciousness and state otherwise


If casuslty is a minor then you need permission from the parents however if not present then consent i s implied however witnesses are essential

You must obtain a person permission as some may refuse your help such as on religious grounds. 

Without their consent it could be deemed as assault. 

An unconscious casualty are not able to give consult and could deteriate very quickly without yuor assistance so you can administer first aid to help improve their condition. 

If they regain consciousness and tell you to stop then you must do so. 

Children don't always know what is best for them so first aid may be required but where possible obtain the consent of the parents. 

Legally if parents cannot give consent then you may carry on however ensure you have a witness present and ensure you consider the childs state of mind and calm them down. 

Consent types

Expressed consent means a person understands your questions and gives you permission to give care, in other words they are conscious. The victim must be able to clearly communicate his or her wishes for expressed consent to count. Sometimes expressed consent is given non-verbally via a gesture, for instance, if a person nods his head when asked a question.

Expressed consent must come from adults who are not impaired. Never attempt to touch or give treatment to a person who refuses to give consent. 

Implied consent is consent that's not expressly granted. It usually happens when you're unable to communicate with the victim. Most commonly, this is because he or she is unconscious.

Under 18, you must obtain consent from the parent or guardian if he or she is present. If they refuse consent, call 911 and wait for emergency medical services to arrive.

First Aid - Consent refusal

An injured person may not give you consent for various reasons, if you attempt to administer first aid without their consent you could leave yourself open to assault charges or even sexual assault if of the opposite sex to you. 

Possible reasons for refusal:

  • Religious beliefs

  • Embarrassing personal problem

  • Opposite sex to first aider

  • Dazed or confused due to injury

Woman in White

Under the Mental Capacity Act (2005) (2) a person is presumed to have the mental capacity to make their own decisions unless proved otherwise.

 It is important that the casualty is not coerced or pressured into accepting treatment, rather they are helped to make an informed decision: 

  • Can the casualty self-treat?  Do you need to be involved in the treatment?

  • If the casualty does not want you to treat them, will the casualty accept treatment from someone else?

  • Is the casualty aware of the seriousness of their injury or condition?

Judgement of consent

There are also some cases where the first aider may have to exercise a level of judgment in treating a victim who may initially refuse. 


Under the Mental Capacity Act (2005) (2) a person is presumed to have the mental capacity to make their own decisions unless proved otherwise. Proving it is the hard part however an example would be if a person has a serious head wound and you are concerned about the level of blood loss leading to unconsciousness then you have a duty of care to that individual.

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Some examples of where you would need to question the persons ability to make the right decision regarding first aid treatment: 

  • Intoxicated

  • Irrational (i.e. delusional, insane or confused due to the injuries)

  • A minor

  • Suffering from learning difficulties

In these cases you should dial 999 and get professional help, if need be give the following details:

  • Description of the person

  • Description of what they are wearing

  • Details of the injury

  • What you believe is going to happen

  • Direction of travel 

In some circumstances you can follow the individual and give directions to the emergency operator however only if it is safe for you to do so.