Does identifying a discharge as "against medical advice" confer legal protection?
BACKGROUND
One in every 65 to 120 discharges from general hospitals are against medical advice and have an expected increased risk of adverse consequences and subsequent litigation. Does the term "against medical advice" confer legal protection?


METHODS
We searched the MEDLINE and PsychInfo databases for relevant articles. We also searched the national medico-legal databases of LEXIS-NEXIS. Additional case law was obtained through a search for "against medical advice" in the West Premise CD-ROM database of New York State cases.


RESULTS
We found 8 relevant cases. There was no case in which "against medical advice" was entirely protective, though partial protection existed in some cases.


CONCLUSIONS
Since patients are admitted voluntarily to a general hospital, a discharge against medical advice is merely a withdrawal of the original consent.
Devitt
P J
PJ
Department of Psychiatry, State University of New York Health Science Center, Syracuse 13210, USA. cncdpjd@omh.state.ny.us
Devitt
A C
AC
Dewan
M
M
D017809:Fatal Outcome; D005260:Female; D006761:Hospitals; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007603:Jurisprudence; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence*; D009518:New York; D010351:Patient Discharge / Q000331:legislation & jurisprudence*; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*; D014481:United States