Clearly, a multitude of potential consent problems can exist for the emergency physician. It is difficult at times to balance the concepts of patient autonomy with the desire to provide optimal medical care. Experienced emergency physicians should be able to individualize the type of consent needed in a particular situation, based on a clinical evaluation of the case. Some general principles apply, but no strict rules can guide the physician in every case. Documentation of consent and refusal of treatment are critical for quality of patient care and legal liability reasons. Principles of what is good, "appropriate" legal consent usually follow from good medical care and strict concern for the patient's health and rights.