title: The importance of a proper against-medical-advice (AMA) discharge: how signing out AMA may create significant liability protection for providers.
abstract: BACKGROUND
  Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications.
  
  
  OBJECTIVE
  The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge.
  
  
  CONCLUSIONS
  In this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication.
  
  
  CONCLUSIONS
  The authors conclude that a properly executed discharge can provide significant legal protection from liability risks.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21209, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Levy
authors.forename: Darren P
authors.initials: DP
authors.lastname: Mareiniss
authors.forename: Corianne
authors.initials: C
authors.lastname: Iacovelli
mesh_terms: D030881:Disclosure / Q000331:legislation & jurisprudence; D004282:Documentation; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence*; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence; D016743:Mental Competency / Q000331:legislation & jurisprudence; D010351:Patient Discharge / Q000331:legislation & jurisprudence*; D012308:Risk Management; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*; D014481:United States