It should be easy. Just like a hairdresser who deals with a client who does not want the haircut which the hairdresser believes would suit the client best. A lot of people simple make a comparison of the advantages and disadvantages of treatment and then deicide. And how a patient weighs advantages and disadvantages depends on personal preferences family situation religion age and other stuff. Just accept what the patient wants and move on to the next patient. I mean if I go to the hospital with a broken leg and I am fully competent and I get a diagnosis of another issue which I prefer to leave untreated then that is my right. I am still entitled to have my leg fixed even if I decline treatment for any other issues which might be diagnosed. A lot of people become afraid to go to a hospital for an issue they DO want treatment for because they worry that they might be pressured into other treatments.
Let them be, and let them go home! If they don't want it, you absolutely can't force it on them. I got hit by a car in 2017 and I refused medical treatment. That's my decision... not any Dr's decision.
Patients have right to refuse, patients have the right to sue to if doctors violate. Patients have the right to bare arms when life is in danger agaisnt their own will.
I am an 65 yr old woman who has been a DNR for 6 yrs. I have no family,and even if I did they would respect my decision. No person on this earth could ever convince me otherwise.
I have had multiple surgeries on my feet and belly over the last couple of years. Every time I have been recommended and even prescribed painkillers, opiates, I always refuse. Never regretted it and never became an addict.
People are dirty...They will often make a family member feel hopeless, in light of a mental condition. The patient might misunderstand what is happening. This is why they have four steps that must be present in order to override a no medical treatment request....people are ruthless enough to trick family members into death or life.
Some people will refuse the medical treatment because of personal circumstances, such as, they’re fine to come to the ER, but will balk at being admitted. This can happen a lot in the case of addicts and alcoholics, who would be cut off from their drug of choice, or it could be they are older, live alone, and have to take care of their pets, etc. because there’s no one else who will do it, or help them out during an extended stay. The addicts will also make up a lot of excuses why they can’t go to the ER that have nothing to do with the drug to try and hide that fact. Some will even leave the hospital AMA any chance they get. It’s sad, but even if an addict, if they’re of sound mind, and can pass the assessment, they still have the right to refuse, even if it endangers their life.
No one has the right to force inject drugs into a concuss persons body. It's kidnaping and assault if they do. Only paramedics finding a person unconcuss have the right to try to help that person. Would you go into somebody's house and do remodeling and bring stuff in and take stuff out without the home owners permission. How much more are our bodies a house for us. We need to respect another persons peoperty. No one is incompetent. Someone invented that word.
I would try to inform the patient on the benefits and drawbacks of taking a particular course of treatment, and vice versa. If the patient has capacity and Gillick competence, it is their decision at the end of the day and I ought to respect their autonomy, My role as a doctor is solely to ensure that they're fully informed when making their decision. I could also probe into why they don't want the treatment and maybe try and work around their concerns that way to clear up any misconceptions.
Listening to this just now-I'd ensure the person understood the information and that their capacity in understanding information, weighing the pros and cons to make their own decision and communicate their decision was not impaired. I'd respect their decision if they had capacity, however, make sure that they made an informed decision-in that they were aware of the implications fully but also try and understand why they were not keen on treatment suggested-perhaps they have a very valid reason personal to them that at this point in time they were unable to agree with any treatment recommended and support them in their decision. Alternatively a next-best approach could be used so that we were still supporting them.
educate patient on their choice to refuse medical treatment(what could possibly occur since they refused), and document they refused treatment in their chart.
patient refuse treatment: - mental health capacity act 2005; adults assumed to have capacity (unless proved otherwise) to make decisions regarding own medical treatment must respect autonomy and decision made; do not need to have patient explain decision, even if deemed unwise from HP perspective - HP should still provide advice & education of all available treatment methods and ensure decision not made from place of MISinformation > supports informed decision making, empowers patients to participate in making decisions on their healthcare within their best interests - refusal of one treatment doesn't necessarily mean refusal of all, HP should support patient by advising them on their OPTIONS, alternatives and each risk / benefit / impact of no treatment (GMC) - enables patient to come to balanced decision - HP have duty to promote positive health & wellbeing, remember health is holistic (BPSS)
A patient refusing to go to hospital is something I have encountered many many times, especially for home visits, it also came up in my colleagues exam. Very helpful
I'm an American citizen in my own country. If only my white American woman doctor who's been in "practice" for 45 years knew this. I've been gaslighted and threatened by the last 6 "doctors" I've seen for trying to make my own healthcare decisions. I make grievances and nothing comes of it. Why do doctors get away with violating my rights? If I can't afford to sue, it leaves me no recourse. Believe me.
You can find more information on the topic on British Medical Association Guidance for doctors on consent General Medical Council Decision making and consent Department of Health Reference guide to consent for examination or treatment, second edition.
How do you obtain a signature for a refusal during COVID? Keep in mind patients are not going to the clinic physically nor do they have a patient portal access. What steps should be taken to fully cover yourself legally?
I will let them know that they have right to do so as long as they have the capacity. - I will find out why they don't want the treatment. - I will validate their reason and try to throw more light and educate if necessary. - I will find out if they know the benefit of the treatment - If they know what could possibly happen if they don't - I will shared light on these(Benefit and Consequences) I will also talk about side effects of treatment and how they outweigh the risk. - I will access mood MIPASSECG for depression, C-FIRST for GAD. I at this point, I must have assessed capacity to a great extent. -I will ICE/FIFE the patient and conclude my counselling - Provide them with self-help materials and websites, Let them know what to do if certain symptoms develop, give them follow-up if necessary -let them know I am always available to help should they change their mind.
‘Competent minors’ (Gillick competent children under 16 and young people of 16 and 17 years of age, who are presumed to have capacity) have the right refuse treatment. The right of child to refuse treatment is not absolute. If treatment is refused, treatment can still be given with parent’s or guardian’s consent or by a court order.
You do not force any child to have treatment against their will you do not force anyone to go to hospital and you don't force anyone to stay alive if someone doesn't want treatment then you are not allowed to forcefully treat them against their will everyone has the right to make their own decisions about themselves and you doctors will not be forcing treatment on anyone especially not me I keep a knife I'm my room in case anyone tries to hospitalise me against my will and anyone who tries to approach me and detain me to take me to hospital against my will gets stabbed without warning so stay back and DON'T you dare try to force me to stay alive.
I think that patients who refuse treatment can have significant ethical implications for both themselves and their healthcare providers. Here are some of the ethical considerations that I think patients should take into account when considering whether to refuse treatment: Informed consent: Patients have the right to make informed decisions about their healthcare. If a patient refuses treatment, they should ensure that they fully understand the risks and benefits of that decision and any potential consequences. Autonomy: Patients have the right to make decisions about their own healthcare. Refusing treatment can be seen as an exercise of this autonomy, provided that the patient is making a decision based on their own values and beliefs rather than external pressure or coercion. Non-discrimination: Patients should not refuse treatment based on discriminatory reasons, such as the personal characteristics of their healthcare provider or other patients. Duty to care: Patients should be aware that refusing treatment may have consequences for their health and wellbeing. They should consider the potential impact on their healthcare providers, who have a duty to provide care to patients who need it. Resource allocation: If a patient refuses treatment due to concerns about resource allocation, they should be aware that healthcare providers have a duty to allocate resources fairly and equitably. Refusing treatment may not necessarily result in a redistribution of resources to other patients. Ultimately, I think that some physicians play the system in order to get paid more, while others try to recommend treatment for the benefit of the patient. I think overall, physicians should always recommend treatment if indicated and for the benefit of the patient. I believe that physicians try their best to help patients. As a current medical students, how can I better service my future patients in this way? Deviany PE, Ganti AK, Islam KMM. Factors Associated With Treatment Refusal and Impact of Treatment Refusal on Survival of Patients With Small Cell Lung Cancer. Oncology (Williston Park). 2021 Mar 15;35(3):111-118. doi: 10.46883/ONC.2021.3503.0111. PMID: 33818051.
Treatment refusal is something doctors frequently deal with. How do you approach patients refusing treatment?
It should be easy. Just like a hairdresser who deals with a client who does not want the haircut which the hairdresser believes would suit the client best. A lot of people simple make a comparison of the advantages and disadvantages of treatment and then deicide. And how a patient weighs advantages and disadvantages depends on personal preferences family situation religion age and other stuff. Just accept what the patient wants and move on to the next patient. I mean if I go to the hospital with a broken leg and I am fully competent and I get a diagnosis of another issue which I prefer to leave untreated then that is my right. I am still entitled to have my leg fixed even if I decline treatment for any other issues which might be diagnosed. A lot of people become afraid to go to a hospital for an issue they DO want treatment for because they worry that they might be pressured into other treatments.
Let them be, and let them go home! If they don't want it, you absolutely can't force it on them. I got hit by a car in 2017 and I refused medical treatment. That's my decision... not any Dr's decision.
Respect people. If they don't want treatment then so be it
Patients have right to refuse, patients have the right to sue to if doctors violate. Patients have the right to bare arms when life is in danger agaisnt their own will.
I am an 65 yr old woman who has been a DNR for 6 yrs. I have no family,and even if I did they would respect my decision. No person on this earth could ever convince me otherwise.
Just checking on you. I'm DNR also, and I do not regret the decision.
I have had multiple surgeries on my feet and belly over the last couple of years. Every time I have been recommended and even prescribed painkillers, opiates, I always refuse. Never regretted it and never became an addict.
If somebody refuses mental health treatment, respect their wishes. I don't care if they're incompetent.
If a patient refuses any treatment, if they’re shot or stabbed up etc… you should refuse treatment if you want.
Agree. The incompetent criterias are also so freaking subjective. They can just label anyone they want basically.
People are dirty...They will often make a family member feel hopeless, in light of a mental condition. The patient might misunderstand what is happening. This is why they have four steps that must be present in order to override a no medical treatment request....people are ruthless enough to trick family members into death or life.
Sometimes doctors only listen to key words or phrases and diagnose based off of limited information.
What about doctors refusing to treat patients
Some people will refuse the medical treatment because of personal circumstances, such as, they’re fine to come to the ER, but will balk at being admitted. This can happen a lot in the case of addicts and alcoholics, who would be cut off from their drug of choice, or it could be they are older, live alone, and have to take care of their pets, etc. because there’s no one else who will do it, or help them out during an extended stay. The addicts will also make up a lot of excuses why they can’t go to the ER that have nothing to do with the drug to try and hide that fact. Some will even leave the hospital AMA any chance they get. It’s sad, but even if an addict, if they’re of sound mind, and can pass the assessment, they still have the right to refuse, even if it endangers their life.
Hello doctor! What do you think are the pros and cons of patient refusal to medical treatment?
No one has the right to force inject drugs into a concuss persons body. It's kidnaping and assault if they do.
Only paramedics finding a person unconcuss have the right to try to help that person.
Would you go into somebody's house and do remodeling and bring stuff in and take stuff out without the home owners permission.
How much more are our bodies a house for us. We need to respect another persons peoperty.
No one is incompetent. Someone invented that word.
I would try to inform the patient on the benefits and drawbacks of taking a particular course of treatment, and vice versa. If the patient has capacity and Gillick competence, it is their decision at the end of the day and I ought to respect their autonomy, My role as a doctor is solely to ensure that they're fully informed when making their decision. I could also probe into why they don't want the treatment and maybe try and work around their concerns that way to clear up any misconceptions.
Perfect.
Id respect their decision, tell them the risks of them not taking the treatment plan, then show them other ways we could help them
Listening to this just now-I'd ensure the person understood the information and that their capacity in understanding information, weighing the pros and cons to make their own decision and communicate their decision was not impaired. I'd respect their decision if they had capacity, however, make sure that they made an informed decision-in that they were aware of the implications fully but also try and understand why they were not keen on treatment suggested-perhaps they have a very valid reason personal to them that at this point in time they were unable to agree with any treatment recommended and support them in their decision. Alternatively a next-best approach could be used so that we were still supporting them.
educate patient on their choice to refuse medical treatment(what could possibly occur since they refused), and document they refused treatment in their chart.
This video was very helpful for me to understand the rights patients have in making healthcare decisions.
Medical staff must not do anything without the patient's informed consent.
patient refuse treatment:
- mental health capacity act 2005; adults assumed to have capacity (unless proved otherwise) to make decisions regarding own medical treatment
must respect autonomy and decision made; do not need to have patient explain decision, even if deemed unwise from HP perspective
- HP should still provide advice & education of all available treatment methods and ensure decision not made from place of MISinformation > supports informed decision making, empowers patients to participate in making decisions on their healthcare within their best interests
- refusal of one treatment doesn't necessarily mean refusal of all, HP should support patient by advising them on their OPTIONS, alternatives and each risk / benefit / impact of no treatment (GMC)
- enables patient to come to balanced decision
- HP have duty to promote positive health & wellbeing, remember health is holistic (BPSS)
A patient refusing to go to hospital is something I have encountered many many times, especially for home visits, it also came up in my colleagues exam. Very helpful
Glad you found the video useful
I'm an American citizen in my own country. If only my white American woman doctor who's been in "practice" for 45 years knew this. I've been gaslighted and threatened by the last 6 "doctors" I've seen for trying to make my own healthcare decisions. I make grievances and nothing comes of it.
Why do doctors get away with violating my rights? If I can't afford to sue, it leaves me no recourse. Believe me.
Have you received help?
It's like human traficking.
Do you have a reference for where u got this info from please?
You can find more information on the topic on
British Medical Association Guidance for doctors on consent
General Medical Council Decision making and consent
Department of Health Reference guide to consent for examination or treatment, second edition.
@@DrErwinKwun Thank you, this video was so helpful for me!
How do you obtain a signature for a refusal during COVID? Keep in mind patients are not going to the clinic physically nor do they have a patient portal access. What steps should be taken to fully cover yourself legally?
I'd suggest you get in touch with your medical indemnity who is in a better position to give you medicolegal advice.
Unfortunately anyone can refuse even children under The Gillick Competence
U saved my life thnx
I will let them know that they have right to do so as long as they have the capacity. - I will find out why they don't want the treatment. - I will validate their reason and try to throw more light and educate if necessary. - I will find out if they know the benefit of the treatment - If they know what could possibly happen if they don't - I will shared light on these(Benefit and Consequences) I will also talk about side effects of treatment and how they outweigh the risk. - I will access mood MIPASSECG for depression, C-FIRST for GAD. I at this point, I must have assessed capacity to a great extent. -I will ICE/FIFE the patient and conclude my counselling - Provide them with self-help materials and websites, Let them know what to do if certain symptoms develop, give them follow-up if necessary -let them know I am always available to help should they change their mind.
Even children can refuse treatment under The Gillick competance
Do children also have right to refuse treatment?
‘Competent minors’ (Gillick competent children under 16 and young people of 16 and 17 years of age, who are presumed to have capacity) have the right refuse treatment. The right of child to refuse treatment is not absolute. If treatment is refused, treatment can still be given with parent’s or guardian’s consent or by a court order.
Dr Erwin Kwun thank you
You do not force any child to have treatment against their will you do not force anyone to go to hospital and you don't force anyone to stay alive if someone doesn't want treatment then you are not allowed to forcefully treat them against their will everyone has the right to make their own decisions about themselves and you doctors will not be forcing treatment on anyone especially not me I keep a knife I'm my room in case anyone tries to hospitalise me against my will and anyone who tries to approach me and detain me to take me to hospital against my will gets stabbed without warning so stay back and DON'T you dare try to force me to stay alive.
Hippocrates said... "We should be our own doctor..." true dat...🎉🎉
I think that patients who refuse treatment can have significant ethical implications for both themselves and their healthcare providers. Here are some of the ethical considerations that I think patients should take into account when considering whether to refuse treatment:
Informed consent: Patients have the right to make informed decisions about their healthcare. If a patient refuses treatment, they should ensure that they fully understand the risks and benefits of that decision and any potential consequences.
Autonomy: Patients have the right to make decisions about their own healthcare. Refusing treatment can be seen as an exercise of this autonomy, provided that the patient is making a decision based on their own values and beliefs rather than external pressure or coercion.
Non-discrimination: Patients should not refuse treatment based on discriminatory reasons, such as the personal characteristics of their healthcare provider or other patients.
Duty to care: Patients should be aware that refusing treatment may have consequences for their health and wellbeing. They should consider the potential impact on their healthcare providers, who have a duty to provide care to patients who need it.
Resource allocation: If a patient refuses treatment due to concerns about resource allocation, they should be aware that healthcare providers have a duty to allocate resources fairly and equitably. Refusing treatment may not necessarily result in a redistribution of resources to other patients.
Ultimately, I think that some physicians play the system in order to get paid more, while others try to recommend treatment for the benefit of the patient. I think overall, physicians should always recommend treatment if indicated and for the benefit of the patient. I believe that physicians try their best to help patients. As a current medical students, how can I better service my future patients in this way?
Deviany PE, Ganti AK, Islam KMM. Factors Associated With Treatment Refusal and Impact of Treatment Refusal on Survival of Patients With Small Cell Lung Cancer. Oncology (Williston Park). 2021 Mar 15;35(3):111-118. doi: 10.46883/ONC.2021.3503.0111. PMID: 33818051.