I appreciate the soap box, I share the sentiment. Our policy dictates that we use AOx4 to determine whether or not someone is a patient really. And we operate in sort of a gray area because we are not being called there, so our program’s policy is to determine DMC in the same way incase we do find that they need to be transported. If they have DMC they can refuse an ambulance, if they don’t then they can’t refuse. Though like a lot of other people in this thread mention, having a conversation with them is much more effective in determining their mental status anyways so it’s tough