At my facility if the patient is totally confused we defer to the family. If no family then we treat the patient. We have a legal obligation to treat the patient if they are incapable of making the decision themselves unless the family defers the treatment if they are involved.
This is why we get so many DT patients. The police find them on the side of the road, motel room, etc and they are legally obligated to bring them to the hospital for medical treatment...
Gosh whatever happened to "drunk tanks"
The frequent flyers that my unit gets (b/c they get put on Ativan Gtt's that do diddly squat even at 20mg/hr) don't want to be rehabilitated, god knows we've tried, so why make them go through that he^^ and put us through it also?