ArticleActa anaesthesiologica Scandinavica2026
Use of Coercion or Persuasion in Prehospital Treatment in the Region of Southern Denmark: A Retrospective Study.
Article in Acta anaesthesiologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe use of coercion or persuasion raises ethical challenges but may be justified when prehospital patients require immediate treatment and are unable to consent. This study aims to describe the characteristics of coerced or persuaded adult pre-hospital patients in the Region of Southern Denmark.
methodsA descriptive analysis of ambulance contacts in the Region of Southern Denmark from January through June 2022. We identified all cases meeting the predefined inclusion criteria for coercion or persuasion, with or without police involvement. We classified cases into four categories: coercion (forced admission with police involvement), necessity or urgent need for treatment, persuasion with police involvement, and persuasion without police involvement. Additionally, we describe the study population's substance use, instances of self-harm, and the overall police involvement in managing these patients.
resultsWithin 39,021 prehospital patient contacts, 6743 cases indicated that coercion or persuasion could have occurred. In 416 cases (1.1% of all prehospital contacts), coercion or persuasion was confirmed. Of these, 65 patients were forcibly admitted to the hospital. Forty-six patients received non-patient-sanctioned treatment justified by necessity or an urgent need. Fifty patients were persuaded with police involvement, and 255 were persuaded through paternalistic means without police involvement. The median age of the coerced patients was 56 years; 54.8% being men. 26.9% of patients subjected to coercion were under the influence of substances. 17.8% of all coerced patients exhibited self-harming behaviours, such as attempting suicide, self-harm, or suicidal thoughts. The police were involved in 31.5% of cases of coercion.
conclusionCoercive measures or persuasion to consent were identified in a small proportion of prehospital contacts. When they occur, the most common form is persuasion without police involvement, but other forms of coercion are also observed. The study emphasises the need for greater attention to this issue to ensure the appropriate use of coercion and persuasion during emergencies. EDITORIAL COMMENT: This study presents experience from one region of Denmark with ambulance missions where the patient was uncooperative but needed acute medical care. Different approaches were commonly implemented in this circumstance, to try to minimise harm related to administering urgent or emergent care.
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