With the patient’s permission, speak with family, clergy or another mediator if you think this might help the patient reconsider his or her refusal. Consider a mental health referral if the patient has overwhelming anxieties about receiving care or shows psychiatric comorbidities and is willing to be evaluated. 3
Full Answer
What to do when a patient refuses initial life-sustaining treatment?
When a patient refuses initial life-sustaining treatment, respectfully explore the underlying reason for the refusal. This allows the healthcare team to identify alternative options that may be equally medically effective and also acceptable to the patient.
Does refusing chemotherapy improve quality of life?
A study that evaluated the quality of life of 140 cancer patients who had refused, discontinued, or completed chemotherapy revealed that the quality of life of patients who refused or discontinued chemotherapy was no different than that of patients who completed treatment [10].
Is it true that “chemotherapy was not administered?
This conclusion was apparently drawn from a response in the database which was based on documentation in the medical records that “chemotherapy was not administered. It was recommended by the patient’s physician, but this treatment was refused by the patient, a patient’s family member, or the patient’s guardian.” 1
Should we close the door on refusal of cancer treatment?
Should we close the door on the continued care and follow-up of these patients? Although the refusal of cancer treatment is a serious concern and has been shown to reduce the effectiveness of treatment and decrease survival duration after diagnosis [1, 2], the phenomenon itself has been scarcely studied.
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.
What do you do when the family of a patient refuses to acknowledge the client's condition and treatment plan?
When patients, families disagree on treatment: 6 ways forwardGet to know the patient's family. ... Minimize confusion. ... Help everyone identify their values. ... Encourage the patient to be open. ... Preserve confidentiality. ... Don't hesitate to call in help.
How would you handle it if a patient refuses care?
Taking the following steps can protect your patients' rights and your practice.Patient Education, Understanding, and Informed Consent. ... Explore Reasons Behind Refusal. ... Involve Family Members and Caregivers. ... Document Your Actions. ... Keep the Door Open.
What do you do if someone refuses treatment for cancer?
If you feel your loved one is refusing treatment because of denial, or because of fear of undergoing treatment, talk to the oncologist. You may want to visit a counselor or support group together.
What is the nurse's legal and ethical responsibilities toward the patient who refuses medical care or treatment?
They must maintain patient confidentiality and observe the right to refuse treatment. Nurses should also be involved in informed consent, medical treatment in an emergency, and continuity of care.
What action would you take if a resident refuses medication?
Possible action that can be taken Patient refuses medication • Try to identify why the resident has refused the medication, their beliefs, understanding of what the medicine is for and consequences of not taking the medication. Establish if there is a pattern of refusal. Address any issues identified.
Who should you inform when a service user refuses to take prescribed medication?
If, for some reason, the person you care for is unwilling to take their medicines, talk to their GP or pharmacist. They may be able to suggest a form of the medicine that's more acceptable than tablets.
How do you document patient refusal?
DOCUMENTING INFORMED REFUSALdescribe the intervention offered;identify the reasons the intervention was offered;identify the potential benefits and risks of the intervention;note that the patient has been told of the risks — including possible jeopardy to life or health — in not accepting the intervention;More items...
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.
What happens when you refuse chemotherapy?
Studies have reported rates of less than 1% for patients who refused all conventional treatment [4] and 3%–19% for patients who refused chemotherapy partially or completely [5–9]. We tend to think that refusing therapy leads to a poorer quality of life as the disease progresses without treatment.
Can you say no to cancer treatment?
You don't have to have treatment. People with very advanced cancers sometimes find they'd rather treat the pain and other side effects of their cancer so that they can make the best of the time they have remaining. If you choose not to be treated, you can always change your mind.
What do you say to someone going through chemo treatments?
Here are some ideas:"I'm not sure what to say, but I want you to know I care"."I'm sorry to hear that you are going through this"."How are you doing?""If you would like to talk about it, I'm here"."Please let me know how I can help"."I'll keep you in my thoughts".
What is patient autonomy?
Patient autonomy has traditionally been one of the most prominent principles of American medical ethics, but often patients don’t make decisions about their care alone. Some choose to involve family members, even sometimes allowing the family’s desires to supersede their own. Respecting autonomy necessarily means respecting patients’ decisions.
How can physicians engage patients in decision making?
Physicians can engage patients about decision-making in ways that are inclusive of family input, and help consider possible roles of surrogate decision-makers for patients who do not have decision-making capacity.
Was chemotherapy not administered?
It was recommended by the patient’s physician, but this treatment was refused by the patient, a patient’s family member, or the patient’s guardian.” 1.
Is there any area of cancer medicine that has evolved more over the past 50 years than antineoplastic chemotherapy?
Maurie Markman, MD. There is probably no area of cancer medicine that has evolved more over the past 50 years than antineoplastic chemotherapy. In their early days, cytotoxic drugs, which initially evolved from wartime efforts to develop debilitating and deadly chemical weapons, were principally employed as last-ditch efforts in the management ...
Is chemotherapy a part of cancer care?
Today, chemotherapy has become a component of standard-of-care cancer management, routinely utilized in patients in the metastatic, adjuvant, neoadjuvant, and maintenance settings.
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.
Why did Joan Crawford refuse treatment?
In the 1960s, film actress Joan Crawford refused treatment for her pancreatic cancer because of her faith as a Christian Scientist.
What is the importance of preparing for the end of your life?
That means getting important documents together, and storing them with a lawyer or in a safe deposit box. That might include insurance records, bank statements, trusts, and a will.
Can cancer be cured?
It’s not the easiest thing in the world to come to grips with, but not all cancer cases can be cured. Sometimes, cancer progresses to a point where it can’t be treated, and sometimes treatment simply stops working. Even when treatment may extend a person’s life, some people find that the side effects of that treatment makes life unbearable.
Is refusing cancer treatment a medical decision?
That’s why it’s important to recognize that refusing cancer treatment is not only a medical decision, but a personal decision, as well.
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 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 .
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 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 ...
Why do patients make this decision?
Patients make this decision when they believe treatment is beyond their means. They decide to forgo treatment instead of draining their bank accounts. Those who live in a country with a for-profit healthcare system may be forced to choose between their financial health and their physical health.
What happens when a patient refuses life-sustaining treatment?
When a patient refuses initial life-sustaining treatment, respectfully explore the underlying reason for the refusal. This allows the healthcare team to identify alternative options that may be equally medically effective and also acceptable to the patient. In the end, the patient has the right to accept or refuse life-sustaining medical treatment.
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 ...
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.
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.
Can you stop curative treatment?
However, when treatment options are aimed at prolonging the patient's life, and no acceptable curative treatment option is available, patients may opt to cease medical treatment. Even when curative options are available, patients may not be willing to undergo the physical trauma, time involved, or associated emotional distress.