Ambulance officers who are unable to treat a patient due to the patient's refusal of consent have a duty to advise police (or other custodians) of the patient's need for medical assessment, by analogy with the duty on a custodian transferring a person to another custodian to pass on relevant medical information. However, a plaintiff who refused medical treatment must establish on the balance of probabilities that he or she would have accepted treatment if taken to hospital; failure to do so is fatal to causation. Under s 5D(3)(b) of the Civil Liability Act 2002 (NSW), the plaintiff's post-harm statements about what they would have done are inadmissible, but evidence of the plaintiff's subjective state, feelings, and circumstances at the relevant time remains admissible and may support inferences about hypothetical conduct. Police protocols, though not having statutory force, may inform the content of the general law duty of care owed to persons in police custody.
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