Refusal of care: the physician-patient relationship and decisionmaking capacity.
Problems of refusal of care, among the most common ethical dilemmas in the emergency department, are also often the most difficult to resolve, pitting 2 conflicting duties, that of helping patients and that of respecting their autonomy, against each other. Using a case presentation as a backdrop, this article offers a practical approach to patients who refuse treatment, including assessment of decisionmaking capacity but emphasizing the role of trust, communication, and compromise in these cases.
Simon
Jeremy R
JR
Center for Bioethics and Emergency Department, Columbia University Medical Center, New York, NY 10032, USA. js1115@columbia.edu
D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D003142:Communication; D003657:Decision Making; D006801:Humans; D008297:Male; D016743:Mental Competency; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics; D016312:Treatment Refusal / Q000941:ethics