When patients in need explicitly refuse life-sustaining emergency treatment, the physician must choose between the undesirable options of forgoing beneficial treatment and forcing treatment on a competent but unwilling patient, both of which have potential ethical and legal consequences.
Full Answer
What happens if a patient refuses life-sustaining emergency treatment?
When patients in need explicitly refuse life-sustaining emergency treatment, the physician must choose between the undesirable options of forgoing beneficial treatment and forcing treatment on a competent but unwilling patient [1], both of which have potential ethical and legal consequences.
Do you have a right to refuse non-life threatening treatment?
Non-Life-Threatening Treatment Decisions. Most patients in the United States have a right to refuse care if the treatment is being recommended for a non-life-threatening illness. You have probably made this choice without even realizing it.
Can I refuse medical treatment?
In addition, there are some patients who do not have the legal ability to say no to treatment. Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness or injury.
Can a hospital be held liable for refusing to treat you?
Yes. In many cases, a hospital can be held liable for refusing to treat a seriously hurt person in an emergency situation. Courts realize that emergency room (ER) patients generally need immediate medical attention, and failure to treat them is more than likely to lead to an aggravated injury or even death.
Can a patient refuse lifesaving treatment?
Every competent individual has the legal right to refuse lifesaving medical treatment. Therefore, a health care provider cannot force medical care upon a patient without his/her consent even in life threatening-situations.
What should you do if 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.
At which of the following times can the patient's right to refuse medical treatment be denied?
Non-Life-Threatening Treatment Most people in the United States have a right to refuse care if treatment is for a non-life-threatening illness.
What is the term called when a patient refuses treatment?
Informed refusal is where a person has refused a recommended medical treatment based upon an understanding of the facts and implications of not following the treatment. Informed refusal is linked to the informed consent process, as a patient has a right to consent, but also may choose to refuse.
Can you be forced to have medical treatment?
You cannot legally be treated without your consent as a voluntary patient – you have the right to refuse treatment. This includes refusing medication that might be prescribed to you. (An exception to this is if you lack capacity to consent to treatment.)
Is it ethical 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.
Can you be forced to go to hospital?
Adults usually have the right to decide whether to go to the hospital or stay at the hospital. But if they are a danger to themselves or to other people because of their mental state, they can be hospitalized against their will. Forced hospitalization is used only when no other options are available.
Is it a human right to refuse medical treatment?
The Human Rights Court has confirmed that Article 8 protects our physical, moral and psychological integrity, as well as our right to choose. Failing to respect someone's competent refusal of medical treatment, and providing treatment against their will, is therefore protected against by Article 8.
Is it a constitutional right to refuse medical treatment?
The Fourteenth Amendment provides that no State shall "deprive any person of life, liberty, or property, without due process of law." The principle that a competent person has a constitutionally protected liberty interest in refusing unwanted medical treatment may be inferred from our prior decisions.
What does refusal of treatment mean?
refusal of treatment a declining of treatment; it may be either informed refusal or not fully informed.
Can a patient leave the hospital?
Generally, yes. You can leave even if your healthcare provider thinks you should stay. But it will be documented in your record as discharged against medical advice (AMA).
Why is refusal of treatment an ethical dilemma?
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 rights of a patient who refuses treatment?
In addition, there are some patients who do not have the legal ability to say no to treatment. Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness or injury: 1 Altered mental status: Patients may not have the right to refuse treatment if they have an altered mental status due to alcohol and drugs, brain injury, or psychiatric illness. 6 2 Children: A parent or guardian cannot refuse life-sustaining treatment or deny medical care from a child. This includes those with religious beliefs that discourage certain medical treatments. Parents cannot invoke their right to religious freedom to refuse treatment for a child. 7 3 A threat to the community: A patient's refusal of medical treatment cannot pose a threat to the community. Communicable diseases, for instance, would require treatment or isolation to prevent the spread to the general public. A mentally ill patient who poses a physical threat to himself or others is another example.
What is the best way for a patient to indicate the right to refuse treatment?
Advance Directives. The best way for a patient to indicate the right to refuse treatment is to have an advance directive, also known as a living will. Most patients who have had any treatments at a hospital have an advance directive or living will.
What is the end of life refusal?
End-of-Life-Care Refusal. Choosing to refuse treatment at the end of life addresses life-extending or life-saving treatment. The 1991 passage of the federal Patient Self-Determination Act (PSDA) guaranteed that Americans could choose to refuse life-sustaining treatment at the end of life. 9 .
How can a patient's wishes be honored?
Another way for a patient's wishes to be honored is for the patient to have a medical power of attorney. This designates a person to make decisions on behalf of the patient in the event they are mentally incompetent or incapable of making the decision for themselves.
What must a physician do before a course of treatment?
Before a physician can begin any course of treatment, the physician must make the patient aware of what he plans to do . For any course of treatment that is above routine medical procedures, the physician must disclose as much information as possible so you may make an informed decision about your care.
What is a threat to the community?
A threat to the community: A patient's refusal of medical treatment cannot pose a threat to the community. Communicable diseases, for instance, would require treatment or isolation to prevent the spread to the general public. A mentally ill patient who poses a physical threat to himself or others is another example.
What are the four goals of medical treatment?
There are four goals of medical treatment —preventive, curative, management, and palliative. 2 When you are asked to decide whether to be treated or to choose from among several treatment options, you are choosing what you consider to be the best outcome from among those choices. Unfortunately, sometimes the choices you have won't yield ...
What is the dilemma of emergency medicine?
One of the greatest dilemmas for emergency physicians occurs when a patient refuses medical treatment that is necessary to sustain life and health. When patients in need explicitly refuse life-sustaining emergency treatment, the physician must choose between the undesirable options of forgoing beneficial treatment and forcing treatment on a competent but unwilling patient [1], both of which have potential ethical and legal consequences. The “emergency privilege” does not permit physicians to treat competent patients with emergency conditions who refuse treatment; but how does one assess an injured patient’s decision-making capacity?
What is the emergency exception?
The emergency exception is based on the presumption that a reasonable person would consent to treatment to preserve life and health if he or she were able. Conversely, the patient who is alert, communicative, and comprehends the situation has the ability to direct his or her health care. The grey areas lie in between.
What are the limitations of determining DMC?
In the emergency setting, there are limitations on determining DMC. When faced with medical emergencies requiring urgent action and decision making, the emergency practitioner does not have the luxury of time to consult psychiatric professionals, an ethics committee, or hospital legal counsel.
Can a comatose patient be intubated?
Certainly, a comatose patient, a severely demented patient, or an intubated, head-injured patient lacks decisional capacity. Under the “emergency exception,” immediate intervention can proceed without informed consent in order to prevent death or serious disability.
What are ethical issues in assisted reproduction?
There are many related ethical issues like determining who are the parents, whether someone should be able to carry a child for another couple, whether that person should be paid for those services. That’s a burgeoning area.
What is the role of an ethicist in a physician?
When the physician isn’t able to do that in a supportive way for the patient and the family, the ethicist’s role should be to advise the physician and the family about what the best ethical choice would be in the situation. Of course, no one has to follow the ethicist’s advice.
Do medical schools have ethics?
Yes, every medical school in the United States must have some instruction on ethical issues in medicine because it’s a requirement for accreditation. But the extent of the curriculum and the topic areas are not uniform.
Can a patient refuse a blood transfusion?
Back in the day it would not be uncommon to override a patient’s wishes, such as if the patient refused a blood transfusion because of their religious beliefs. That was then, this is now. A number of benchmark court cases have recognized the patient’s right to refuse life-sustaining treatments such as transfusion, ventilation, nutrition, and hydration. That was a major shift.
Who must refuse medical treatment?
For one, the person refusing to provide medical treatment to the patient must be someone who is employed by the hospital. In addition, that person must also possess the authority to decide which patients can or cannot receive treatment. In most cases, this generally will include any hospital staff that is in charge of the treatment and care ...
What happens if a doctor refuses to admit a patient?
On the other hand, if a doctor refuses to admit or treat a patient without ever considering the patient’s current medical condition, then some courts will find that the hospital should be held liable for refusing to admit or treat the patient.
What happens if a patient arrives in critical condition and fails to treat them?
For instance, if a patient arrives in critical condition and failing to treat them will result in severe injuries or possibly death, then the hospital will be held responsible for turning away a patient who needs immediate medical attention.
What does it mean when a hospital is short on resources?
If the hospital is short on resources (e.g., not enough beds, staff, medicine, overcrowded, etc.); When the hospital believes that the patient would receive better treatment at a different facility; and/or. If the hospital lacks the appropriate equipment or type of medical personnel required to properly treat a patient’s injury or illness.
Can hospitals refuse to admit patients?
Hospitals can refuse to admit or treat certain patients without incurring liability. Although hospitals cannot deny treatment to individuals for discriminatory purposes (e.g., race, gender, sex, etc.), they can do so for other reasons, such as: If the hospital is short on resources (e.g., not enough beds, staff, medicine, overcrowded, etc.);
Can a hospital refuse a patient's medical treatment?
According to the terms of the Emergency Medical Treatment and Active Labor Act (“EMTALA”), a hospital cannot refuse a patient medical treatment if it is an emergency, regardless of whether the patient is insured or not. Thus, if a patient requires immediate medical attention or is in active labor, then a hospital can be held liable ...
Can a hospital be held liable for refusing to admit a patient?
As discussed above, there are certain situations where a hospital can be held liable for refusing to admit or treat patients, such as if the hospital is denying treatment based on discriminatory reasons. Another example of when a hospital may be held liable for refusing treatment is during an emergency situation.
What is an emergency medical emergency?
Any incident that is severe or life-threatening, Any incident where bodily functions or organs are seriously impaired, Any incident where delivery is imminent in a pregnant woman. No matter what your insurance status, hospitals and emergencies room must provide adequate care if your situation qualifies as an emergency.
Do you have to know your rights if you don't have health insurance?
Know Your Rights! Just because you don’t have health insurance does not mean you’re without protection. Know your rights. As an uninsured individual, you may not be familiar with what rights are available to you in an emergency.