Full Answer
Can a patient refuse life-sustaining medical treatment?
In the end, the patient has the right to accept or refuse life-sustaining medical treatment. After a competent patient chooses to forego a life-sustaining treatment or procedure, the healthcare team is faced with only one option: We must support the wishes of the patient that will ultimately result in his or her death.
What is the right to refuse life saving treatment?
Right To Refuse Lifesaving Treatment. Under such circumstances, the patient’s right to refuse or terminate life-sustaining treatment would override competing state interests in preserving life and the exercise of the right would not amount to suicide.
What does it mean to refuse end-of-life care?
Choosing to refuse treatment at the end of life addresses life-extending or life-saving treatment. The right to refuse end-of-life care was guaranteed to Americans in 1991 with the passage of the federal Patient Self-Determination Act (PSDA).
What is an example of a right to refuse care?
A mentally ill patient who poses a physical threat to himself or others is another example. Most patients in the United States have a right to refuse care if the treatment is being recommended for a non-life-threatening illness.
What is it called when someone refuses medical 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.
What if a patient refuses life saving 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.
What is forced medical treatment?
Involuntary treatment (also referred to by proponents as assisted treatment and by critics as forced drugging) refers to medical treatment undertaken without the consent of the person being treated.
What happens when a patient refuses hospice?
If palliative care is available in your area see if she might agree to accept that rather than hospice, since she will be able to continue curative treatments while receiving palliative care. Some patients may also agree to be admitted briefly to a home care service for evaluation of their potential for improvement.
What is Nonmaleficence in healthcare?
The principle of nonmaleficence requires that every medical action be weighed against all benefits, risks, and consequences, occasionally deeming no treatment to be the best treatment. In medical education, it also applies to performing tasks appropriate to an individual's level of competence and training.
What makes a patient incompetent?
An individual determined to be incompetent can no longer exercise the right to accept or refuse treatment. Competency is a legal term referring to individuals “having sufficient ability… possessing the requisite natural or legal qualifications” to engage in a given endeavor.
What is forced hospitalization called?
Forced hospitalization means keeping someone in the hospital against his will. It's also called involuntary confinement or civil commitment.
What should a doctor do if a patient refuses life saving treatment for religious reasons?
Three physician experts suggest that to discern when to accommodate a patient's refusal of treatment on religious grounds, doctors should embrace medicine's traditional orientation toward preserving and restoring health.
What does the court consider when deciding an individual's right to refuse lifesaving treatment?
The courts, in deciding an individual’s right to refuse lifesaving treatment, even if there is a possibility of a cure, consider the competency of the individual as to whether an individual has knowingly and validly chosen such a right, and whether there is a compelling state interest that justifies overriding the individual’s decision.
What is the right to refuse medical treatment?
In re L.H.R., 253 Ga. 439 (Ga. 1984), the court stated that a competent adult patient has the right to refuse medical treatment in the absence of conflicting state interest and such a right rises to the level of a constitutional right which is not lost because of the incompetence or youth of the patient. However, the doctrine that every human being of adult years and sound mind has a right to determine what shall be done to his own body was reiterated in Cruzan v. Dir., Mo. Dep’t of Health, 497 U.S. 261, 269 (U.S. 1990).
What is the mootness doctrine in People v. Brown?
App. 3d 159 (Ill. App. Ct. 1st Dist. 1997), the court held that the State could not override the patient’s competent refusal of treatment decision to save the life of her fetus. The court found that (1) the case satisfied the public policy of the state mootness doctrine, (2) a blood transfusion was an invasive medical procedure, (3) being a competent adult, the patient had an absolute right to refuse medical treatment, (4) religious objections to treatment were constitutionally protected, (5) the State’s interest in the preservation of life, the prevention of suicide, the protection of third parties, and the ethical integrity of the medical profession did not override the patient’s decision to refuse lifesaving treatment.
What should a physician do in an emergency situation?
However, a physician should respect the refusal of treatment from a patient who during the emergency situation is capable of providing consent.
Can a patient refuse life-sustaining treatment?
The competent adults irreversibly sustained by artificial life support and enduring physical and mental pain and suffering had the right to terminate treatment. Under such circumstances, the patient’s right to refuse or terminate life-sustaining treatment would override competing state interests in preserving life and the exercise of the right would not amount to suicide.
Can a religious person refuse medical treatment?
In a majority of cases, courts have upheld the right of an adult to refuse potentially life–saving medical treatment on religious grounds, unless the individual is (1) mentally incompetent, (2) the parent and sole provider of young children, or (3) a pregnant woman. Where there are minor children dependent upon the survival of the patient, the medical control of one’s body is relative. Therefore, the need of protection of innocent third parties arises and where there are such minor children dependent on the patient, the court will not recognize the patient’s right to refuse medical treatment even when there is a hope for cure. But, if the court finds that the interest of the child is not affected and the child will be adequately cared for both financially and emotionally, then the court will not order any such lifesaving treatment. The court acts according to the state’s interest in protecting children when the lives and health of unborn children is threatened by their mother’s decisions.
Does the state have the right to refuse treatment?
The state’s interest in the preservation of life does not invariably control the right to refuse treatment in cases of positive prognosis. Therefore, consideration should be given to the nature of the treatment involved, the complexity of the procedures, the extent of the commitment and endurance required of a person who has to undergo the proposed treatment along with the physical and emotional burdens imposed on the patient by compelling him/her to accept such treatment.
How to help a patient who refuses life-sustaining treatment?
Be consciously aware not to impose your values or beliefs onto your patient who refuses life-sustaining treatment. Allow the patient to make the end-of-life care choices that reflect his or her values and beliefs so that quality of life can be optimized. As nurses, our goal is not only to promote our patients' health, but also enhance the remaining time that our critically and terminally ill patients have with their family and loved ones.
What does it mean to refuse medical treatment?
The term competent means the patient understands that refusing to accept treatment will result in eventual death. Some patients may elect to refuse specific medical treatments, such as blood transfusions, because of religious beliefs, but will accept synthetic blood plasma expanders that aren't made of donor blood.
Why do some people refuse blood transfusions?
Some patients may elect to refuse specific medical treatments, such as blood transfusions, because of religious beliefs, but will accept synthetic blood plasma expanders that aren't made of donor blood. When a patient refuses initial life-sustaining treatment, respectfully explore the underlying reason for the refusal.
What ethical dilemmas can a nurse face?
A: One of the greatest ethical dilemmas a nurse can encounter is when a patient refuses life-sustaining treatment—any procedure, medication, intervention, or use of medical technology that can postpone death. As healthcare providers, we're instilled with the primary objective to save lives. However, when treatment options are aimed ...
Can medical technology prolong life?
Medical technology can potentially allow the prolonging of a patient's life. However, these treatments carry risks and may also cause the patient physical, spiritual, or emotional pain. Many patients state that they would prefer their remaining life to be filled with family, friends, and enjoyable activities.
Is it illegal to forgo a life-sustaining procedure?
After a competent patient chooses to forego a life-sustaining treatment or procedure, the healthcare team is faced with only one option: We must support the wishes of the patient that will ultimately result in his or her death. Forcing treatment on a patient without his or her informed consent is illegal. Ensure that the risks and benefits of all treatment options are discussed with the patient so that he or she can make an informed decision that reflects his or her values and beliefs.
Is it illegal to force a patient to take medication without their consent?
Forcing treatment on a patient without his or her informed consent is illegal . Ensure that the risks and benefits of all treatment options are discussed with the patient so that he or she can make an informed decision that reflects his or her values and beliefs.
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.
How to refuse treatment?
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 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 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 .
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.
When a patient has been sufficiently informed about the treatment options offered by a healthcare provider, the patient has the right?
When a patient has been sufficiently informed about the treatment options offered by a healthcare provider, the patient has the right to accept or refuse treatment, which includes what a healthcare provider will and won't do.
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 ...
When treatment over a patient's objection would be appropriate?
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 are the first few questions in a treatment plan?
The first few questions consider the imminence and severity of the harm expected to occur by doing nothing as well as the risks, benefits, and likelihood of a successful outcome with the proposed intervention. Other questions consider the psychosocial aspects of this decision—how will the patient feel about being coerced into treatment? What is the patient’s reason for refusing treatment? The last question concerns the logistics of treating over objection: Will the patient be able to comply with treatment, such as taking multiple medications on a daily basis or undergoing frequent kidney dialysis?
Is there anything out there to help health care professionals approach the problem of delivering medical treatment against the wishes of patients?
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.
Can you force dialysis on a patient who resists?
As Dr. Rubin stated, one cannot force three times weekly dialysis sessions on a resistant patient even if it means that the patient will die without the treatment.
What does the court consider when deciding a child's refusal?
Courts also consider whether the parent (s) agree with their child’s refusal. While parents’ rights can be trumped by the state, courts provide a great deal of latitude for parental decision making, as in E.G.’s case when the mother’s agreement may have ultimately determined the court’s decision [9]. In contrast, when the court did not believe the child had a true ability to express his or her wishes (as in Daniel’s case) or did not have an opportunity to hear the child’s perspective (Shannon’s case), it favored protecting the child over granting decision making power to the parents [10, 11].
Why did Daniel refuse chemotherapy?
The refusal was based on their religious practice of Nemenhah, a Native American healing practice in which Daniel was a medicine man and which forbade chemotherapy because of a prohibition against doing harm [10]. Daniel was unable to articulate why he opposed the chemotherapy beyond the notion of “do no harm,” and experts placed his reading below ...
What was the condition of E.G.?
E.G. E.G. was a 17-year-old Jehovah’s Witness with leukemia who refused medically necessary blood transfusions on the basis of religious belief, a decision her mother supported [9]. Without transfusions, professionals expected E.G. to live no more than a month, and either way her long-term prognosis was poor—persons with her condition had a predicted survival rate of 20 to 25 percent [9]. Experts evaluated E.G. and agreed about the following: she was mature (one specialist placed her at the maturity level of someone between 18 and 21), her refusals were based on a sincere religious belief and not a desire to die, and she fully understood that the consequences of her decision would be death [9]. A trial court appointed a temporary guardian for E.G. to consent to transfusions on her behalf and found her mother guilty of medical neglect, but Illinois’ highest court overturned the decision in 1989, holding that E.G. had a right to refuse the blood transfusions and her mother was innocent [9]. (At this point, the case was technically moot for E.G.’s purposes, because she had turned 18.) The court was swayed by the fact that E.G.’s mother agreed with the refusal and suggested that the outcome could have been different if E.G.’s mother had wanted her to seek treatment.
Can a minor give consent to a medical procedure?
Most states provide certain universal exceptions, instances in which minors can give medical consent. One is for emergency care when a parent is not available in time to provide consent [7]. Another exception is for emancipated minors, who are deemed legally independent from their parents in all legal capacities, including medical decisions [7]. Some states have statutes that specify types of care for which parental consent is not required, such as treatment for sexually transmitted infections, treatment for substance abuse or mental health, or requests for contraceptives [8]. Lastly, states may have “mature minor” doctrines, under which minors can petition the court to recognize that they fully understand the treatments and consequences of their decisions and should therefore be allowed to make treatment decisions independently, either in contradiction to their parents’ wishes or without consulting their parents [7]. Courts often view teenagers’ refusal of life-saving therapies as an extension of the mature minor rules.
Can a teenager refuse lifesaving therapy?
Three stories help illustrate the key considerations a court generally weighs when asked whether a teenager should be allowed to refuse life-saving therapies.
Does every refusal involve religion?
While not every refusal involves religion, many do, whether the belief is on the part of the child, the parent, or both. The freedom to practice religion is strongly undergirded by the First Amendment of the Constitution, which prohibits Congress from making any law that interferes with it [12].
Can Jehovah's Witnesses refuse blood transfusions?
The right to refuse life-saving therapies on religious grounds is also strongly defined, most notably the refusal of blood transfusions by Jehovah’s Witnesses [3]. Whether the same rights apply to minors (typically defined as younger than 18, though the definition varies by state) is more complex.
