An adult patient with capacity has the right to refuse any medical treatment, even where that decision may lead to their death or the death of their unborn baby. This right exists even where the reasons for making the choice seem irrational, are unknown or even non-existent. The right to refuse treatment extends to all medical treatment including but not limited to ventilation, cardio-pulmonary resuscitation (CPR), dialysis, antibiotics and artificial feeding and hydration. Treating a person who has validly refused treatment could constitute an assault or battery.
Full Answer
Does a doctor have the right to refuse a patient treatment?
May 24, 2018 · KP: A simple example of when treatment over a patient’s objection would be appropriate is if a psychotic patient who had a life-threatening, easily treatable infection was refusing antibiotics for irrational reasons. Treatment would save the patient’s life without posing significant risk to the patient.
What to do when someone refuses treatment?
May 24, 2016 · Explore Reasons Behind Refusal. 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.
When May a physician refuse to treat a patient?
Background A core aspect of American bioethics is that a competent adult patient has a right to refuse treatment, even when the physician believes that the treatment would be beneficial. At such a time it is easy to either question the patient’s capacity to make the decision or try even harder to convince them to change their mind.
When can you refuse to treat a patient?
The overriding ethical principle in this case is respect for patient autonomy. Ethically and legally patients have the right to refuse life-sustaining treatment, including artificial nutrition and hydration. The Patient Self-Determination Act (1991) is a federal statute that reinforces patients' rights to refuse artificial hydration and nutrition.
What would you do if a patient refuses care?
Understand their story Try to understand the patient/family's story before you try to change their mind. This means suspending your attitude toward their decision and as openly and non-judgmentally as possible, understanding the reasons for their decision.
What should a nurse 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.
Is a patient allowed to refuse treatment?
Under federal law, the Patient Self-Determination Act (PSDA) guarantees the right to refuse life sustaining treatment at the end of life.Apr 16, 2015
What to do if a patient refuses to go to hospital?
Keep trying, asking questions, listening, and reflecting. Help them feel heard and ask again. Continue to say things like, “I'm really worried about you. I'm thinking we should just go get checked out by a doctor to see what's going on.” Reassure them that you'll stay with them and help them through the process.
How do you convince someone to get medical treatment?
Roffman says the general message should be along the lines of, “I'm concerned about you and your wellbeing, and I believe going to the doctor would help you take care of your health.” Translation: Don't say anything that could be construed as, “Here's what's wrong with you, and here's a long list of how you're failing ...Nov 6, 2018
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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 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.
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 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 happens if a doctor refuses to give informed consent?
If he does not, the doctor may face disciplinary action by the General Medical Council, plus possible civil and criminal proceedings in battery. Informed refusal, just like informed consent, comprises three elements: The patient must be competent. He or she must have sufficient information to be able to make a choice.
What is an advance refusal of treatment?
Patients may also make advance refusals of treatment – more commonly known as living wills or advance directives. These are statements made by patients when competent about how they wish to be treated should they become incompetent at a later stage.
What happens if you fail to abide by a valid advance directive?
In general, failure to abide by a valid advance directive leaves the doctor vulnerable to civil or criminal proceedings in battery and disciplinary proceedings before the GMC , which has stated in its guidance 2: 'You must respect any refusal of treatment given when the patient was competent.'.
What is competent adult patient?
Adult competent patients are entitled to accept or reject treatment options. Their reasons do not have to be sound or rational; indeed, they do not have to give any reasons at all. Where a competent adult refuses treatment recommended by guidelines, the doctor is bound to respect that refusal. If he does not, the doctor may face disciplinary action ...
What is the duty of a doctor?
The duty on the doctor is to ensure that patients understand the implications of their proposed course of action. Information must be provided in objective terms, if necessary recruiting colleagues with special expertise to provide further advice, but scaremongering is out of the question.
What was the impact of the 1990s on healthcare?
Both have been heralded as significant boosts to improved standards of healthcare. But the two may also conflict where an informed patient decides, ...
Why can't doctors wash their hands?
Equally, doctors cannot wash their hands of patients simply because they will not toe the line. The duty of care remains despite the refusal. In Good Medical Practice, 3 the GMC states: 'If you feel that your beliefs might affect the treatment you provide, you must explain this to patients, and tell them of their right to see another doctor.'.
