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: Tags: Clinical Ethics Decision making Health Care capacity consent patient autonomy syndicated Source Type: blogs