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CLAIMS Rx DIRECTORY


RISK MANAGEMENT PUBLICATION

Refusal of Treatment—Liability, Patient Safety and Ethical Considerations

July 2020

This article summarizes a number of NORCAL closed claims that illustrate various informed refusal scenarios. In many of these cases, an appropriate informed refusal process and documentation could have reduced patient harm and dissuaded the patient from filing a lawsuit. Where the patient did file a lawsuit, documentation of the informed refusal strengthened the defense.

This article includes healthcare ethics content, which may help meet CME credit ethics requirements in some states.

CASE ONE
Documentation of Informed Refusal and Leaving Against Medical Advice

CASE TWO
No Documentation of Leaving Against Medical Advice

CASE THREE
No Documentation of Referral Refusal

CASE FOUR
Hard-to-Believe Patient Refusal of Treatment

CASE FIVE
Lack of Documentation of the Risks of Not Obtaining Recommended Testing

CASE SIX
Birth Plans and C-Section Refusal

 

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