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Informed Refusal
I offered my best advice, but the patient still doesn’t want the treatment. What should I do?
Electing which treatment to undertake (or none at all) is certainly the patient’s right. However, because there’s an even greater risk of a bad outcome when the patient refuses to accept medical advice, we recommend that you document the patient’s response on an “informed refusal” form.
This form follows the informed “consent” format. At the end, however, instead of electing to undergo the therapy or treatment, the patient states that they will forego it. This approach more clearly articulates particular risks and benefits, rather than merely noting in the chart that treatment was discussed and the patient’s decision.
By using a refusal form, patients will better appreciate the potentially serious consequences of their decisions. In many cases, this opportunity to reflect will be sufficient to convince them to pursue the proposed treatment, after all. On the other hand, should an unfortunate outcome occur, just what was communicated to the patient will be well documented.
A final point to remember: if a patient refuses to sign an informed refusal form, the next best response is simply to document what you’ve related, along with their reaction, in the medical record.
[CLICK HERE FOR SAMPLE INFORMED REFUSAL FORM.]
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The risk management advice presented in this Site is intended as general information of interest to physicians and other healthcare professionals. The recommendations and advice published on this Site do not reflect or establish a standard of care and do not establish rules for the practice of medicine. The publication of this information is not intended as an offer to insure such conditions or exposures, or to indicate that MAG Mutual Insurance Company will underwrite such risks for the reader. Our liability is limited to the specific written terms and conditions of actual insurance policies issued.
