Someone who is an adult and has full mental capacity can refuse medical treatment, regardless of the situation. Even if you're facing a deadly disease, you can simply choose to go with the flow and accept your fate. In these situations, patients choose a better quality of life over the length of life.
Nevertheless, there are some situations where you might be forced to undergo medical treatment against your will. This is the case with kids, mentally incapable people, and individuals who are considered a threat to society. If you're not sure which group you belong to, you should contact your healthcare advocate and ask for advice.
In this article, we’ll explain the concept of consent and how all these rules might apply to you.
What is the Right to Refuse and Informed Consent?
Informed consent and the right to refuse are two concepts that go hand in hand. Informed consent, in particular, refers to situations where a patient has received all relevant information about the diagnosis and potential treatment and that he has understood the options. For a patient to meet this criterion, he needs to understand the following:
- Diagnosis
- Suggested treatment
- Benefits and risks
- Alternative treatments
- Benefits and risks of declining
A patient should act out of free will when accepting a proposed treatment. There shouldn’t be coercion of any kind, and the patient should understand he has the option of declining assistance. Then again, there are situations where coercion is the best course of action, especially if a patient wants to receive treatment but is scared of the procedure.
In most cases, a patient can verbally give informed consent to a medical provider. They don’t have to sign anything for the procedure to proceed. The only exception to this rule is clinical trials and other types of research, where everything has to be properly documented.
Rights to Refuse Exceptions
When a person is under duress or going through a medical emergency, a healthcare provider can bypass informed consent. This rule was introduced as a life-saving measure in situations where a person might not be able to provide verbal consent or when time is of the essence.
Besides this, here are other categories of patients who can’t refuse treatment:
Mentally Incompetent Patients
If a person doesn't have the mental capacity to understand the treatment and potential outcomes, their guardian can make the decision for them. Alternatively, if a guardian isn't present, a medical provider can make their decision.
It’s worth mentioning that mental incompetence doesn’t only refer to people struggling with mental and intellectual difficulties. It also applies to patients who are under the influence of drugs and alcohol, as well as those who have a brain injury.
Nevertheless, there are also a few exceptions to this rule. For example, there are cases where a patient with Down syndrome or schizophrenia can be deemed competent by their doctor. A healthcare practitioner has to determine if this person meets the necessary criteria that would allow them or disallow them to give consent.
Underage Patients
Similar to people with mental issues, underage patients should be accompanied and consented by their parents. Mothers and fathers get a lot of leeway when deciding the best course of action for their children, except in life-threatening situations. In these cases, a parent must abide by the doctor's instructions regardless of their religious beliefs or customs.
A parent can refuse treatment if the following three requirements aren’t met:
- The treatment will save the child's life
- The treatment will improve the child's quality of life
- All doctors agree that this is the best course of action
There are some situations where a parent can outright refuse treatment, for example, if a child has a terminal illness and medical treatment won’t help them survive.
On the other hand, if a parent refuses to administer treatment and everything indicates this is the best solution, social services can step in and take custody of the infant. Still, it's worth noting that children's medical rights might vary from state to state.
Community Treats
The rarest of three exceptions are community threats. The best example of this is contagions, where the entire population has to be vaccinated or quarantined. We can also add drug-related conditions to the list, where medical practitioners have to act swiftly to prevent spread.
Mandatory vaccination for young kids is among the most common types of community threats. Children get shots against tetanus, measles, mumps, and other contagious diseases at an early age. There are also situations where a court might impose a medical treatment for people with mental illness who would otherwise be a threat to themselves and to others.
Common Examples of Refusals
As a US citizen, you have the right to refuse just about any treatment as long as it isn’t life threatening or highly contagious. A patient can avoid a flu shot, prescription filled, not using crutches, and so on.
People can also avoid treatments due to emotional reasons. For example, if you're afraid of surgery or anesthesia or don't want to disclose your medical history, you can refuse treatment without any consequences.
These rules also apply to end-of-life care, such as DNR (do not resuscitate) orders, living wills, and POLST (physician's orders for life-sustaining treatment). This legislation allows people to die with their dignity intact if they ever become incapacitated and can't provide verbal or written refusal.
Some people don't want to leave big medical bills to their loved ones or don't want to prolong their lives. If you want your wishes to be honored, you should consider giving medical power of attorney to one of your family members. This empowers them to make a decision on your behalf in case of a mishap.
Knowing Your Rights
As mentioned in the beginning, you should work with your patient advocate as well as medical practitioners to make the best decision for yourself and your family. Among others, an advocate can represent you in front of medical staff, explaining to them where you stand with the proposed treatment.