Suggest a referral to a physician who speaks the patient’s primary language. Be sure to document in the medical record the patient’s refusal and your explanation of the risks and benefits of an interpreter. Improve cultural competence:
Full Answer
How do you deal with a patient who refuses treatment?
Educate the patient as fully as possible about the benefits of treatment recommendations and the risks of no treatment. As much as possible, discover the patient’s reasons for refusing care and discuss these with the patient to see if there are ways to negotiate so that the patient can receive care that is in his or her best interests.
How do you provide sensitive care to patients of diverse cultures?
When in doubt, the best way to provide sensitive care to patients of diverse cultures is to ask. When you initiate care during your initial assessment, ask if there are any cultural or religious practices or beliefs that you need to know about in order to respect and support their needs.
Is it legal to deliver psychiatric care to patients who refuse it?
And there are fairly clear policies and laws concerning the ethics and legality of delivering psychiatric care to patients who refuse it. But there is nothing out there to help health care professionals approach the problem of delivering medical treatment against the wishes of patients who lack decisional capacity.
What are the challenges of cultural diversity in health care?
Challenges of Cultural Diversity in Health care: Protect Your Patients and Yourself. Physicians are increasingly faced with providing care to a multicultural society complicated by literacy issues. Ensuring safe and quality health care for all patients requires physicians to understand how each patient’s sociocultural background affects his ...
What do you do if a patient refuses treatment because of religion?
Simply, if an adult under your care is mentally competent and refuses a treatment, including blood transfusions, surgery, or standard medical care, based on a held religious or cultural belief, the law generally grants this right of choice—even if the consequences of refusal are dire.
How do you deal with refusal of treatment?
Treating ResentmentConsider Why It's Difficult to Forgive.Use Self-Compassion.Try Empathy.Lean Into Gratitude. It's normal to get caught up in all the negative things happening around you. You can bring more happiness and positivity into your life by focusing on the things that are going right.
What should a nurse do when a patient refuses treatment?
If your patient refuses treatment or medication, your first responsibility is to make sure that he's been informed about the possible consequences of his decision in terms he can understand. If he doesn't speak or understand English well, arrange for a translator.
Do patients have the ethical right to refuse treatment?
Competent patients have a right to refuse treatment. This concept is supported not only by the ethical principle of autonomy but also by U.S. statutes, regulations and case law. Competent adults can refuse care even if the care would likely save or prolong the patient's life.
What are some ethical challenges with refusing treatment?
In general, ethical tension exists when a physician's obligation to promote a patient's best interests competes with the physician's obligation to respect the patient's autonomy. “When you don't take your medication, you're more likely to get sick.”
What are the ethical and legal considerations involved in refusing patient service?
Both the ethical opinions and legal precedents agree that a physician may not intentionally and unilaterally sever an existing relationship with any patient, unless the physician provides reasonable notice to the patient, in writing, and sufficient time to locate another physician.
What is the nurse's legal and ethical responsibilities toward the patient who refuses medical care or treatment?
They must maintain patient confidentiality and observe the right to refuse treatment. Nurses should also be involved in informed consent, medical treatment in an emergency, and continuity of care.
When acting against a patient's wishes, is the MCA used?
As a general rule, when acting against a patient’s wishes, the MCA is used to treat physical disorders that affect brain function and the MHA is used to treat primary mental (psychiatric) disorders. In part two of the case scenario the patient’s behaviour has changed.
What is the first step in a mental health case?
The first is to determine the urgency of treatment to see whether common law is applicable. The second is to determine what is being treated—a primary physical (organic) disorder or a primary mental (psychiatric) disorder. We will now explain how to work through these two steps as we look at the evolving case scenario.
What is common law in emergency settings?
In the first part of the case scenario, failure to act immediately and treat the tension pneumothorax would probably result in serious harm to the patient. In such situations there is clearly not sufficient time for a formal assessment of capacity and common law should be used. Common law is widely used in emergency settings, because there is rarely time for consent. Clinicians are often unaware that they are using it and that it is the legal defence of their actions. No specific documentation is needed when using common law. However, the MCA and MHA should be the default legal frameworks when the situation is not immediately life threatening. Box 2 lists the key principles of common law.
Is common law a doctrine of necessity?
View inline. Common law is more informatively known as the “doctrine of necessity” and is only one form of common law, which is based on judgments of individual cases (also known as case law). This differs from statutory law, which is based on acts (of parliament), such as the MCA and the MHA.
Can patients be treated against their wishes?
Patients can be treated against their wishes only if their decision making capacity is impaired and if the proposed treatment is for something serious enough to warrant over-riding their wishes.
Can a section 5 order be used in an outpatient setting?
The patient is already admitted: a section 5 (2) order can be used only in the inpatient setting (but not emergency or outpatients departments, although in some trusts or health boards the clinical decisions unit may count as an inpatient setting)
Can a delirium patient use the MCA before the MHA?
Where possible, the MCA should be used before the MHA. In this case, it would also be appropriate to use the MHA to keep the patient on the ward to treat his mental disorder. If he refused treatment, ongoing treatment of his physical health conditions (femoral and pelvic fracture) would need to take place within the framework of the MCA.
What organizations are concerned with the belief system of a patient?
In fact, organizations like the American Psychiatric Association, American Academy of Family Physicians and American Nursing Association have stressed the need for greater understanding of a patient’s belief systems, particularly when dealing with treatment options and end-of-life issues. The most effective ways for nurses ...
How to deal with spirituality in the hospital?
The most effective ways for nurses and healthcare workers to deal with religion and spirituality in the hospital in three steps: Communication, Support and Accommodation, and Tolerance. Communication. To address spirituality issues effectively, healthcare practitioners should strive to learn as much as they can about their patients’ religious ...
How many people believe that religion is good for medical care?
Up to 66% of patients believe that religious faith could help physicians dispense better medical advice and treatment recommendations. Finally, 62% of patients believe that medical procedures based on spirituality could enhance patient outcomes substantially.
Why is empathy important in medicine?
Besides the approaches discussed above, empathy is a key ingredient in enhancing physician-patient interactions. This is in addition to improving patient care. Empathy also makes patients feel accepted, important, worth saving (even in dire medical situations), well understood, and able to voice their concerns.
Why is it important to open up communication with physicians?
Opening up communication also enables physicians to avoid treatment options that could be unacceptable to patients on religious grounds. It is also worth noting that spirituality can help patients cope with pain caused by serious injuries or terminal illnesses.
What percentage of patients would like physicians to ask about their faith?
In addition, 74% of patients with serious medical conditions would like physicians to ask them about their faith. Of course, physicians should refrain from being judgmental or disparaging their patients’ religious beliefs.
How does faith help in health?
At the same time, 40% of patients harness faith to cope with health challenges, whereas 25% rely heavily on prayer during ill health. Religious faith can also be a source of strength and comfort whenever patients face stressful and challenging health situations. In fact, 67% of patients believe that spirituality could enable medical practitioners ...
What are the routines of a culture?
Everyday routines that the predominant culture takes for granted such as time orientation, eye contact, touch, decision-making, compliments, health-beliefs, health-care practices, personal space, modesty, and non-verbal communication can vary dramatically between cultures, sub-cultures, and religions.
What is a conscientious nurse?
The conscientious nurse can affirm, respect, and nurture all patients through deliberate awareness, acceptance, and asking.
Why are people challenged by inability to obtain, process, and understand basic health information and services?
Studies have shown that people from all age, race, income, and education levels are challenged by an inability to obtain, process, and understand basic health information and services needed to make appropriate health decisions and to follow instructions for treatment.
Why was the treatment delayed for several days?
After several days of delayed treatment because consent for a necessary but nonemergent surgery could not be obtained from the patient, a visiting chaplain of the same nationality explained the cultural requirement that a male be present for a female’s care.
How to assess cultural competence?
Consider taking the following steps: 1 Evaluate any personal attitudes, beliefs, biases, and behaviors that may influence your care of patients. 2 Conduct a self-assessment: Cultural and Linguistic Competence Health Practitioner Assessment available from the Georgetown University National Center for Cultural Competence. 3 Use a communication model such as ESFT or LEARN:
What happens when cultures and languages clash?
When cultures and languages clash, physicians are unable to deliver the care they have been trained to provide. Culturally competent care depends on resolving systemic and individual cultural differences that can create conflicts and misunderstandings.
Why is communication important for a patient?
Effective provider-patient communication leads to an increase in patient satisfaction, better compliance, and improved outcomes. In multicultural and minority populations, the issue of communication may play an even larger role because of behavioral, cognitive, linguistic, contextual, and cultural barriers that preclude effective patient-provider ...
What percentage of the population has the skills to navigate and understand our complex health systems?
AHRQ has found that only 12 percent of the adult population has the skills to navigate and understand our complex health systems—skills reduced by stress and illness. We encourage you to explore the AHRQ Health Literacy Universal Precautions Toolkit.
Does Medicaid cover language access?
In some states, Medicaid plans may call for providing language access. Explain to patients who refuse interpreter services that it is very important to the patient’s care and safety that you and the patient/family member understand each other. Suggest a referral to a physician who speaks the patient’s primary language.
What is the name of the medical term for refusing care from nurses of different race?
Patients refusing care from nurses of different race one of medicine's "open secrets". DETROIT It's been called one of medicine's "open secrets" -- allowing patients to refuse treatment by a doctor or nurse of another race. In the latest example, a white man with a swastika tattoo insisted that black nurses not be allowed to touch his newborn.
What did the Abington Memorial Hospital lawsuit claim?
In another federal lawsuit filed in 2005, three black employees of Abington Memorial Hospital near Philadelphia claimed they were prevented from treating a pregnant white woman by her male partner , who was a member of a white supremacist group. The man used a racial slur when forbidding any care by any African-Americans.
Can doctors refuse to treat people based on race?
The American Medical Association's ethics code bars doctors from refus ing to treat people based on race, gender and other criteria, but there are no specific policies for handling race-based requests from patients.
Can black nurses touch newborns?
In the latest example, a white man with a swastika tattoo insisted that black nurses not be allowed to touch his newborn. That led several black nurses to sue the Michigan hospital, claiming it bowed to his illegal demands, and a rapid settlement in one of their lawsuits. The Michigan cases are among several lawsuits filed in recent years ...