[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [Autonomy and consent](https://durgical.com/en/medical-ethics/areas/autonomy/) › Consent in emergencies and the exceptions to consent

# Consent in emergencies and the exceptions to consent

- Topic

In a life-threatening emergency, with the patient unable to decide and no surrogate available, doctors act on presumed consent.

Updated Nov 5, 2026

## Key points

- Presumed consent: emergency + patient lacks capacity + no surrogate available + intervention prevents death or disability.
- Exceptions: emergency, waiver, therapeutic privilege and incapacity (the surrogate decides).
- A known, valid prior refusal (advance directive) is respected in emergencies too.
- Decree 3380 of 1981, art. 3: an emergency is any condition that endangers life or bodily integrity and needs immediate care.
- Law 1751 of 2015, art. 10 b: emergency care requires no documents or prior payment.

## What it is

Informed consent has few exceptions, and all are narrow. The main one is the emergency: if the patient cannot decide, no surrogate can be reached in time and the intervention prevents death or disability, the person is presumed to accept it. The other classic exceptions are the patient's waiver of information, therapeutic privilege and incapacity (which does not remove consent but moves it to the surrogate). In Colombia, Law 23 of 1981 (arts. 14 and 15) and Decree 3380 of 1981 (arts. 3 and 11) set out the emergency exception.

## The exceptions to informed consent

| Exception | When it applies | Limit |
| --- | --- | --- |
| Emergency | Immediate threat to life, patient lacks capacity, no surrogate in time | Only what the emergency needs; inform afterwards |
| Waiver | A capable patient asks not to be told or delegates to someone else | It must be the patient's own informed choice |
| Therapeutic privilege | Disclosure would cause real and foreseeable harm | Very restrictive; recorded and reviewed |
| Incapacity | The patient cannot decide this question | The surrogate decides, not the doctor alone |

## In clinical practice

- Unconscious trauma patient with no relatives: treat the threat to life and inform as soon as possible.
- Being in the emergency room is not implied consent to everything.
- If a valid refusal by the patient is known (for example, of transfusions), the emergency does not permit ignoring it.
- Once the emergency is over, consent is sought again for anything that is not immediate.

## Legal framework in Colombia

- Law 23 of 1981, art. 14: no intervention without authorisation on minors, unconscious or incapable people unless the emergency requires immediate action; art. 15: consent is sought unless it is not possible; art. 23: no advance payment in emergencies.
- Decree 3380 of 1981 (regulates Law 23): art. 3 defines emergency; art. 4 bars declining care in emergencies; art. 11 waives the risk warning in an emergency or when the patient's mental state and absence of relatives prevent it.
- Law 1751 of 2015, art. 10 b: emergency care without documents or prior payment.
- Law 1098 of 2006, art. 46 item 6: immediate action when a minor's life is in danger and there is no representative or no authorisation.
- Official texts checked on 2026-11-05 at funcionpublica.gov.co.

## Test yourself

Think of the answer, then tap the question to see it.

## What conditions justify acting on presumed consent?

An emergency threatening life or bodily integrity, a patient who cannot decide, no surrogate available in time and an intervention that prevents death or disability.

## What are the classic exceptions to informed consent?

Emergency, the patient's waiver of information, therapeutic privilege and incapacity, in which the surrogate decides.

## How does Decree 3380 of 1981 define an emergency?

As any condition that endangers a person's life or integrity and needs immediate care in the doctor's judgement (article 3).

## Does an emergency allow a doctor to ignore a known, valid refusal by the patient?

No. If a capable patient validly refused that treatment beforehand, the refusal is respected in the emergency too.

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## Connections

## Related 1

- [Informed consent: elements and how to obtain it](https://durgical.com/en/medical-ethics/informed-consent-elements-and-how-to-obtain-it/)

[← All of medical ethics](https://durgical.com/en/medical-ethics/)

Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.

Sources: [Informed Consent](https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/detail/67) (University of Washington, Department of Bioethics & Humanities, 2018); [Truth-telling and Withholding Information](https://depts.washington.edu/bhdept/ethics-medicine/bioethics-topics/detail/82) (University of Washington, Department of Bioethics & Humanities, 2018); [Ley 23 de 1981, por la cual se dictan normas en materia de ética médica](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=68760) (Función Pública, Gestor Normativo, 1981); [Decreto 3380 de 1981, por el cual se reglamenta la Ley 23 de 1981](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=68761) (Función Pública, Gestor Normativo, 1981); [Ley Estatutaria 1751 de 2015, que regula el derecho fundamental a la salud](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=60733) (Función Pública, Gestor Normativo, 2015); [Ley 1098 de 2006, Código de la Infancia y la Adolescencia](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=22106) (Función Pública, Gestor Normativo, 2006).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/medical-ethics/consent-in-emergencies-and-the-exceptions-to-consent/