title: Refusal to medical interventions.
abstract: Refusal to medical interventions is the not acceptance, voluntary and free, of an indicated medical intervention. What the physician should do in case of refusal? It is understandable that the rejection of a validated medical intervention is difficult to accept by the responsible physician when raises the conflict protection of life versus freedom of choice. Therefore it is important to follow some steps to incorporate the most relevant aspects of the conflict. These steps include: 1) Give complete information to patients, informing on possible alternatives, 2) determine whether the patient can decide (age, competency and level of capacity), 3) to ascertain whether the decision is free, 4) analyze the decision with the patient, 5) to persuade, 6) if the patient kept in the rejection decision, consider conscientious objection, 7) take the decision based on the named criteria, 8) finally, if the rejection is accepted, offer available alternatives.
authors.affiliation: Grupo de Trabajo de Bioética de la Sociedad Española de Medicina Interna, España; Unidad de Medicina Interna, Hospital Universitario Fundación Alocorcón, Alcorcón, España.
authors.forename: G
authors.initials: G
authors.lastname: Palacios
authors.affiliation: Grupo de Trabajo de Bioética de la Sociedad Española de Medicina Interna, España; Instituto de Ética Clínica Francisco Vallés, Universidad Europea , Madrid, España. Electronic address: benjaminherreros@gamil.com.
authors.forename: B
authors.initials: B
authors.lastname: Herreros
authors.affiliation: Grupo de Trabajo de Bioética de la Sociedad Española de Medicina Interna, España; Servicio de Medicina Interna, Ibermutuamur, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Pacho
keywords: Decision-making; Freedom of choice; Libertad de elección; Rechazo; Refusal to treatment; Toma de decisiones