Treatment FAQ

what happens when your decision to refuse treatment is not respected

by Jayme Stamm Published 2 years ago Updated 1 year ago

In other words, involuntarily hospitalized patients still have a right to decide what happens to their bodies. Unfortunately, the right to refuse treatment can, and does, result in some patients being locked up in a hospital where doctors then cannot proceed with treatment.

Full Answer

Why would a patient refuse treatment?

Patients may refuse treatments for many reasons, including financial concerns, fear, misinformation, and personal values and beliefs. Exploring these reasons with the patient may reveal a solution or a different approach. Involve Family Members and Caregivers

Can you refuse treatment if you are mentally ill?

A mentally ill patient is another example of a patient that cannot refuse treatment if the person poses a physical threat to himself or others. 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 you choose to refuse treatment at the end of life?

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 

Do Americans have the right to refuse medical treatment?

Most, but not all, Americans have the right to refuse medical treatment. However, there are three exceptions to the right to refuse treatment. They occur when others are subsidizing the patient's income during his or her period of injury, sickness and inability to work.

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 the rules for refusing to treat the patient?

As a rule of thumb, if unnecessary delays in care may cause irreparable harm, physicians can face legal liability for their refusal to treat. If you need urgent medical attention, and a doctor refuses to treat you, you can pursue a medical malpractice suit against the physician and/or the establishment they work for.

In what circumstances does a person have a right to refuse treatment?

When a healthcare provider sufficiently informs you about the treatment options, you have the right to accept or refuse treatment. It is unethical to physically force or coerce someone into treatment against their will if they are of sound mind and are mentally capable of making an informed decision.

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.

How would you deal with a patient who refuses treatment?

Discharging the duty of care following refusal requires the doctor to provide treatment, promoting the patient's best interest but within the limits of the patient's consent. Consent or refusal must be given voluntarily.

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.

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.”

Can you decline medical treatment?

Although the right to refuse medical treatment is universally recognized as a fundamental principle of liberty, this right is not always honored. A refusal can be thwarted either because a patient is unable to competently communicate or because providers insist on continuing treatment.

What does refusal of treatment mean?

refusal of treatment a declining of treatment; it may be either informed refusal or not fully informed.

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 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 the mandate of PSDA?

The PSDA also mandated that nursing homes, home health agencies, and HMOs were required by federal law to provide patients with information regarding advance directives, including do not resuscitate (DNR) orders, living wills, physician’s orders for life-sustaining treatment (POLST), and other discussions and documents.

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 happens if speech language pathologists do not eliminate aspiration?

If treatment procedures do not eliminate aspiration, then the speech-language pathologist must decide whether or not to assist the patient in oral feeding. The concern of course is to reduce the speech-language pathologist's liability should the patient get pneumonia and/or die because of eating orally.

What is the Patient Self-Determination Act?

The Patient Self-Determination Act (1991) is a federal statute that reinforces patients' rights to refuse artificial hydration and nutrition. This right was determined in constitutional law in the case of Nancy Cruzan. Thus, the recommendations of the ethics consultants were solidly based on both ethics and law.

What is the ethical principle of respect for patient autonomy?

Respect for patient autonomy is the primary ethical principle to employ when a patient is able to make deci-sions for him/herself. It may appear to clinicians that the burdens of foregoing tube feeding outweigh the benefits.

Why do speech pathologists want to prevent aspiration?

The speech-language pathologist's wish to prevent aspiration and prolong life conflicts with the patient's wishes for comfort and avoiding life prolongation using tube feeding. Many speech-language pathologists are uncomfortable feeding a patient who aspirates, and may worry about legal liability.

Can you refuse treatment for workers compensation?

If you have been hurt or become sick as a result of your work or your work environment, and you are receiving income through workers' compensation, then you may not have the right to refuse treatment.

Does disability subsidize income during convalescence?

If your injury or sickness is unrelated to your employment but is affecting your ability to work or support yourself , that's when your disability insurance will subsidize your income during your convalescence. Your ability to refuse treatment will vary by insurer.

Can you refuse medical treatment for a disability?

Similar to workers' compensation, people who receive social security disability may also find that they cannot legally refuse medical treatment. When taxpayers are providing you with income because you are sick or hurt, and if that illness or injury can be improved or repaired well enough so you can once again support yourself, you will not be allowed to refuse treatment. If you do, you will yield your right to receive that SSD support. 1 

Can a patient refuse medical treatment?

Most, but not all, Americans have the right to refuse medical treatment . However, there are three exceptions to the right to refuse treatment. They occur when others are subsidizing the patient's income during his or her period of injury, sickness and inability to work. 1 . In most of these cases, a patient may not refuse treatment ...

Can you refuse treatment with Social Security?

Your ability to refuse treatment will vary by insurer. In general, the rules for refusal will be similar to those for Social Security disability and workers' compensation. The disability insurer won't be willing to let you choose not to be treated if that refusal means they will have to pay you more money over a longer period of time. ...

What is the right to treatment?

There is a long legal history on the right to treatment. Much of the law derives from court cases in the previous century involving people who were admitted to state psychiatric hospitals where they languished without proper treatment, sometimes for many years. Laws compelling a right-to-treatment law developed and became instrumental to the quality-controlled public psychiatric hospitals that exist today. In fact, in order for public psychiatric hospitals to receive Medicare and Medicaid (and other third-party) payment, they must obtain the same national certification as academic medical centers and local community hospitals. For patients and families, this means that a person admitted to a public psychiatric hospital has a right to receive—and should receive—the standard of care delivered in any accredited psychiatric setting.

What is involuntary treatment?

For involuntary treatment (treatment without consent ) to be delivered outside of an acute emergency, the doctor and hospital must petition a court to order it. Laws vary from state to state and, of course, no two judges are alike. Generally, judges rule in favor of well-prepared doctors and hospitals that show that.

What does it mean to be admitted to a public psychiatric hospital?

For patients and families, this means that a person admitted to a public psychiatric hospital has a right to receive—and should receive—the standard of care delivered in any accredited psychiatric setting.

How long does an inpatient stay last?

Inpatient stays often last several weeks (or months) longer if court-ordered treatment is required. Notably, as clinicians have seen, once a court order is obtained, almost all patients comply with treatment within a day or so, and then, hopefully, proceed to respond to treatment.

Do patients have the right to refuse treatment?

All patients have both a right to treatment and a right to refuse treatment. These rights sometimes become the centerpiece of debate and dispute for people who are hospitalized with an acute psychiatric illness.

Can insurance refuse to pay for treatment?

Unfortunately, the right to refuse treatment can, and does, result in some patients being locked up in a hospital where doctors then cannot proceed with treatment. What’s worse, and deeply ironic, is that insurance companies may refuse to pay, stating there is “no active treatment.”.

Can you continue a medication after an emergency?

Clinicians cannot continue the medication, even if it could prevent another emergency situation; the patient has the right to decide whether to continue or not.

HOW DOES A PERSON FEEL WHEN THEY ARE ILL?

STAGE 1: When a person finds out that he has an incurable disease, he experiences 5 emotions before starting treatment. At first, the patient thinks that this is not true. He denies illness and is convinced that the doctor was wrong. Then he either ignores the diagnosis or checks the doctor.

WHY DOES THE PATIENT DELAY DIAGNOSTIC AND TREATMENT OF THE DISEASE AT AN EARLY STAGE?

A mild illness like the common cold is often underestimated and delayed in treatment. A person can go to work with a runny nose or cough for weeks. And there are other cases: when a symptom is a sign of the development of a dangerous disease. The patient ignores the disease until it develops into something more serious.

WHAT SHOULD YOU DO IF THE PATIENT REFUSES TO ACCEPT THAT THEY HAVE A DISEASE?

Denial is a natural defense of man. Awareness of a fatal diagnosis leads the patient into shock. All plans and goals now lose their meaning. The patient is not ready to give up the future and therefore behaves as if nothing happened. At this stage, he needs support and help. The patient should feel free to talk about their illness.

WHAT SHOULD BE DONE IF THE PATIENT TRUSTS IN NON-CONVENTIONAL MEDICINE?

Some patients do not trust doctors. Instead of going to the clinic for help, they turn to healers and traditional methods. These actions take important time and reduce your chances of recovery. The most famous example is the actions of Steve Jobs. Instead of immediately starting treatment, he meditated for 6 months.

WHAT SHOULD BE DONE IN THE EVENT THAT THE PATIENT HAS LOST ALL HOPE?

The most difficult case is when the patient ceases to believe in recovery. He understands that illness is his destiny. The patient gives up and floats with the flow of life, waiting for the disease to win. But they give up not because of the severity of the disease. The deeper reason is the loss of the meaning of life.

5 WAYS THROUGH WHICH YOU CAN HELP THE PATIENT

Health is a priority. If symptoms of the disease are noticeable, you need to postpone everything and go for a diagnosis. Loved ones can help by reminding them of the values of health or helping to cope with business. Early diagnosis of the disease can save a person’s life

Article 5-Freedom from Torture

While it may seem odd that I would choose an article that relates to torture, it is actually quite relevant to the medical field. While advancements have been great in our ability to control symptoms and cure disease, many treatments remain unpleasant at best.

About Tammy McKinney, RN

Tammy McKinney is a Registered Nurse from Pennsylvania. After earning her Business Administration degree, she went on to earn her degree in nursing from Pennsylvania College of Health Sciences. With a background in Infectious Disease Nursing, Agency Nursing, and Hospice Care she enjoys sharing her experiences through her writing.

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