When Patients Refuse Treatment
- Patient Education, Understanding, and Informed Consent. The physician’s first responsibility is to ensure that the...
- Explore Reasons Behind Refusal. Patients may refuse treatments for many reasons, including financial concerns, fear,...
- Involve Family Members and Caregivers. Involving family members and other loved ones in the conversation...
Full Answer
What to do when a patient refuses medical treatment?
When Patients Refuse Treatment 1 Patient Education, Understanding, and Informed Consent. The physician’s first responsibility is to ensure that the patient understands the pros and cons of the recommended treatment, says Ana Maria Lopez, MD, ... 2 Explore Reasons Behind Refusal. ... 3 Involve Family Members and Caregivers. ...
Can a doctor force a patient to decline treatment?
"Physicians need to show that the patient's decision to decline treatment was based on a full understanding of all the facts necessary to make that decision," says Holeman. "Physicians cannot force a treatment on a patient, all they can do is educate." Circumstances in which informed refusal should be obtained vary considerably.
When to refuse medical treatment for financial reasons?
Refusing for Financial Reasons. You might also consider refusing treatment if you have been diagnosed with a medical problem that requires very expensive treatment. You may prefer not to spend so much money. Patients make this decision when they believe treatment is beyond their means.
Why do patients decline recommended care?
The most common reason patients decline recommended care is because they lack information. 1 In these cases, a physician’s ethical obligation is to ensure patients understand exactly what they are declining.
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.
What should you do if patient refuses treatment or transport?
If, however, the patient still refuses care or transport, make them aware of all of the risks and rewards of treatment and non-treatment as necessary in implied consent, complete a patient refusal form (usually located on the back of a standard PCR), and obtain the patient's signature.
Can we give treatment to patient who refuses 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 happens when a patient refuses?
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 by the General Medical Council, plus possible civil and criminal proceedings in battery.
What is it 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.
When documenting that a patient has refused a treatment you should include?
Terms in this set (15)Documentation of the refusal of treatment should include: ... Informed consent upholds the ethical principle of. ... informed consent involves telling the patient: ... Signing the Notice of Privacy Protection as mandated by HIPAA is the same as signing an informed consent document for treatment.More items...
What are a few examples of when a patient can refuse treatment?
1 Accordingly, the patient may refuse to be informed about their medical condition and make a decision. An example would be the statement, “I don't want to hear anything from you. I'm not going to the hospital.” They may be informed and then refuse to make a decision. “Wow, that sounds bad either way.
What is the nurse's legal and ethical responsibilities toward the patient who refuses medical care or treatment?
All clients have the legal right to autonomy and self-determination to accept or reject all treatments and interventions. With the exception of emergencies, all aspects of nursing care and interventions must be explained to the patient.
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.
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.
Why must physicians respect the patient's refusal of 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.”
Can you force someone to take medication?
For the most part, adults can decline medical treatment. Doctors and medical professionals require informed consent from patients before any treatment, and without that consent, they are prohibited from forcibly administering medical care.
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.
Is fast facts medical advice?
This information is not medical advice. Fast Facts are not continually updated, and new safety information may emerge after a Fast Fact is published. Health care providers should always exercise their own independent clinical judgment and consult other relevant and up-to-date experts and resources.
Do you need to consult the prescribing information before using a product?
Some Fast Facts cite the use of a product in a dosage, for an indication, or in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted before any such product is used.
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 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 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 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.'.
Who likened a patient's consent to turning the key in a door to unlock it?
Lord Donaldson, when Master of the Rolls, likened a patient's consent to turning the key in a door to unlock it. It is then up to the doctor to decide if the door should be opened by providing treatment, that decision being dependent upon assessing whether doing so would be in the best interests of the patient.
Did Miss T want a blood transfusion?
The day following admission, Miss T announced that she did not want a blood transfusion, although at that time no transfusion had been contemplated. However, later in the day, she went into labour and the baby was delivered by caesarean section.
What happens when a patient refuses treatment?
When patients refuse recommended treatments, physicians are apt to worry not just about their patients’ health and if they are doing everything they can to help them, but also if they will be to blame if the patient suffers a poor outcome. Continue Reading. This problem is neither new nor uncommon.
What are the conflicts that arise over other declinations of care?
More commonly, conflicts can arise over other declinations of care, including non-adherence with medication, treatment, or screening recommendations, by disengaging with their health care providers, or failing to follow-up regularly.
What is the ethical tension between a physician and a patient?
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.
How does harm reduction work?
It attempts to reduce the adverse health consequences that may come from a patient’s unhealthy behaviors while accepting that such patients are likely to continue these behaviors . This is practiced on large scales with needle exchange programs and on smaller scales in physicians’ offices with nicotine replacement therapy.
Do patients want their doctors to decide for them?
At the same time, patients do not necessarily want their physicians to decide for them . Such paternalism, when physicians make unilateral decisions about what is best for patients, is no longer ethically acceptable.
Do competent patients have a right to decline treatment?
Competent patients have a right to decline recommended treatments and physicians have an obligation to respect that right. Although it is frustrating to stand by when patients decline recommended care, it does not mean they wish to decline all help. Keeping patients engaged in their care allows physicians to help when and where they can.
Case Study
- A patient had a long-standing history of coronary artery disease, suffering his first myocardial infarction (MI) at age 47. He had recurrent chest pain a year later and underwent a work up to rule out MI. He was treated medically without invasive procedures. Four years after the first MI, he ca…
Informed Refusal
- Texas law recognizes that physicians must obtain consent for treatment and that such consent be "informed." A variant of informed consent is informed refusal, in which a patient refuses treatment after having been informed of the risks and benefits of the intervention. Many physicians associate the concept of informed refusal with the patient who leaves the ED abruptl…
The Process of Informed Refusal
- As is frequently emphasized in the medical risk management literature, informed refusal is a process, not a signed document. "Physicians need to show that the patient's decision to decline treatment was based on a full understanding of all the facts necessary to make that decision," says Holeman. "Physicians cannot force a treatment on a patient, all they can do is educate." Cir…
Assessing Decision-Making Capacity
- "Although the concept of patient autonomy requires that patients be permitted to make even idiosyncratic decisions, it remains the responsibility of the clinician to assure that no decision is the result of a problem with decision-making capacity or some misunderstanding that needs to be resolved." (4) With regard to obtaining consent for medical interventions, competence and decisi…
Documenting Informed Refusal
- Prudent practice involves comprehensive documentation. As with the informed consent process, informed refusal should be documented in the medical record. In the case study, the jury found in favor of the plaintiffs when faced with a deceased patient and an undocumented patient decision of great importance. A signed refusal for heart catheterization — including the risks, benefits an…
Sources
- Bernat J, Peterson L. Patient-centered informed consent in surgical practice. Arch Surg. 2006 Jan;141(1):86-92.
- Solomon R. Ethical issues in medical malpractice. Emerg Med Clin N Am. 2006 Aug;24(3): 733-747.
- Engel KG, Cranston R. When the physician's medical judgment is rejected. Clinical case 2. Am…
- Bernat J, Peterson L. Patient-centered informed consent in surgical practice. Arch Surg. 2006 Jan;141(1):86-92.
- Solomon R. Ethical issues in medical malpractice. Emerg Med Clin N Am. 2006 Aug;24(3): 733-747.
- Engel KG, Cranston R. When the physician's medical judgment is rejected. Clinical case 2. American Medical Association Virtual Mentor Archives. February 2004. Available at www.ama-assn.org/pub/cate...
- Ganzini L, Volicer L, Nelson W, Fox E, Derse A. Ten myths about decision-making capacity. J Am Med Dir Assoc. 2005 May-June;6(3 Suppl):S100-104.
