Do Patients Have the Right to Refuse Medical Treatment?

Informed Consent

The right to refuse treatment goes hand in hand with another patient right—the right to informed consent. 

Before a healthcare provider can begin any course of treatment, they must make you aware of what they plan to do. That means they must disclose as much information as possible so you can make an informed decision about your care.

When a healthcare provider sufficiently informs you about the treatment options, you have the right to accept or refuse treatment.

It is unethical to physically force or coerce someone into treatment against their will if they are of sound mind and are mentally capable of making an informed decision.

Exceptions

In emergencies, doctors may bypass informed consent if immediate treatment is necessary for someone's safety or to save their life.

In addition, some people do not have the legal ability to say no to treatment. Even in non-emergency situations, some people can not refuse medical treatment.

Mental Capacity

People may not have the right to refuse treatment if they have an altered mental state. Altered mental capacity may be due to alcohol and drugs, brain injury, or psychiatric illness.

Children

A parent or guardian may not refuse life-sustaining treatment or deny medical care for a child—not even if their religious beliefs discourage specific medical treatments. That means parents cannot invoke their right to religious freedom to refuse treatment for a child.

Threat to the Community

A person's refusal of medical treatment cannot threaten the community. For example, infectious diseases might require treatment or isolation to prevent spreading to the general public. Another example is when someone poses a physical threat to themself or others.

Non-Life-Threatening Treatment

Most people in the United States have a right to refuse care if treatment is for a non-life-threatening illness. You have probably made this choice without even realizing it. For example, maybe you didn't fill a prescription, chose not to get a flu shot, or decided to stop using crutches after you sprained an ankle.

You may also be tempted to refuse treatment for more emotional reasons. For example, perhaps you know it will be painful, or you are afraid of the side effects.

Either way, there is nothing illegal about choosing to forgo treatment for any reason. They are personal choices, even if they aren't always wise choices.

End-of-Life-Care Refusal

Some people choose to refuse life-extending or life-saving treatment at the end of life.

The PSDA also mandated nursing homes, home health agencies, and HMOs to provide patients with information regarding advance directives, including:

• Do not resuscitate (DNR) orders
• Living wills
• Physician’s orders for life-sustaining treatment (POLST)

Some people do not want decisions about their care to eventually be decided by someone else when they can no longer make decisions for themselves. So, they may set up advance directives ahead of time that state their wishes.

When people refuse end-of-life care, they often want a better quality of life rather than a longer life that may be less pleasant.

Palliative Care

Declining life-sustaining treatment does not mean you are required to forfeit palliative care.

This type of care can be administered even for patients who do not want to be kept alive.

Before you decide against receiving treatment at the end of your life, be sure you've followed steps to help you make an informed decision. Writing out your wishes can help ensure that those caring for you follow your plans.

Refusing for Financial Reasons

Sadly, those who live in a country with a for-profit healthcare system are sometimes forced to choose between their financial and physical health. As a result, Americans sometimes refuse treatment when they know it will harm their finances.

Therefore, sometimes people refuse treatment when it is beyond their means. So, they forgo treatment to avoid going into debt over high medical bills.

Using Religion to Refuse Treatment

Some religions, like Jehovah's Witnesses and Christian Scientists, may object to specific kinds of medical treatment. Some may be willing to undergo some forms of treatment but restrict or refuse other forms based on their religious beliefs.

Adults may rely on their religion and its tenets to refuse treatment if they choose. However, they have less legal standing when making those choices for their children.

Knowing and Using Your Rights

If you are trying to make a medical decision, take steps to ensure you make the best decision for yourself.

First, work through your options with a professional, such as a patient advocate, who is committed to shared decision-making. The shared decision-making process helps you weigh your values and beliefs against your options to make the best choice for you.

Next, be sure you are allowed to refuse medical treatment and that you are not in a category where refusal is restricted.

Finally, make it formal by drawing up an advance directive and medical power of attorney.

Advance Directives

The best way to indicate the right to refuse treatment is to have an advance directive. This document is also known as a living will.

Advance directives are kept on file with a hospital. They tell the treatment team what your wishes are if you are unable to accept or refuse medical care (like if you were unconscious or dying).

Medical Power of Attorney

Another way for your wishes to be honored is to have a medical power of attorney. This document designates a person who can make decisions on your behalf if you are mentally incompetent or otherwise can't make the decision for yourself.