The Incapacitated Patient ’s Refusal of Recommended Medical Treatment: Is It Justifiable to Treat Over Objection?
Adult patients are
presumed to have decisional capacity and have a right to refuse medical
treatment, not only from an ethical perspective but also a legal one. Patients with capacity have the right of
bodily integrity and personal autonomy, and the right to not be touched without
consent. The situation becomes more
problematic when adult patients, whom have been determined to lack decisional
capacity, actively object to recommended medical treatment or intervention
believed to be in their best interest. For this patient population treatment
over objection becomes a challenging ethical and legal issue that should not be
taken lightly by healthcare providers.
These patients, who may have the ability to not only verbally express
strong preferences against treatment, may also physically resist any bodily
intrusions. In most cases the required
effort to force treatment, using sedation or restraints, becomes ethically
problematic. At the same time, in cases
where it seems apparent that the patient will benefit from the recommended
medical treatment, allowing patients without capacity to not receive this
treatment is ethically troublesome.
There is no universal answer to situations in which patients
without capacity refuse treatment. The
question is: Should we employ a case
specific approach that carefully considers the following factors: the patient’s reason for refusal
(preferences), harms/risks/consequences...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Bioethics Today Tags: Clinical Ethics Decision making Health Care capacity consent patient autonomy syndicated Source Type: blogs