The patient refuses to cooperate. What can you do? What should you do?
More matters that need to be mentioned
Restrictions on the patient. We need to remember that, even if a patient is thought to be able to make his own decisions, there may be some situations when he can be held in the hospital against his will. These usually are the cases when the patient is psychiatrically or medically unstable (unable to care of himself), but also if the patient is at risk of harming himself or others, subject of elder abuse, or suspected of being an abuser.
Restrictions on the practitioner. Even if the patient is determined to be lacking decision-making capacity, we, physicians, cannot perform tests, procedures, or do the placements without the patient’s agreement.
Informed consent doctrine is applicable in this case, and if performing a test or procedure is necessary (except life- or limb-saving emergencies, when doctrine of physician prerogative applies), or if there a disagreement in post-discharge placement, the emergency guardianship may need to be pursued.
Disclosure
Dr. Graypel reports no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
