title: Patients' refusal of recommended treatment.
abstract: When patients require information to decide whether to accept recommended treatments, a question in both law and ethics is whether the same information is adequate whether they consent or refuse, or whether refusal requires more or repeated information. Refusals of recommended treatment can carry increased risks for patients' well-being and so require more emphatic disclosure without imposing pressure. A related question is whether guardians of dependents who would decline recommended treatment for themselves--for instance on religious grounds--can similarly decline it for their dependents. When pregnant women, children, and adolescents are able to give consent for recommended treatment, the question arises whether they are equally competent to refuse it and prevent their decisions being overridden by guardians or courts. Consenting to and refusing medical treatments recommended in one's own or dependents' best interests might not be the same sorts of decisions and could require different levels of disclosure and capacity.
authors.affiliation: Faculty of Law, Faculty of Medicine and Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada. Electronic address: bernard.dickens@utoronto.ca.
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Dickens
authors.affiliation: Faculty of Law, Faculty of Medicine and Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D002648:Child; D003657:Decision Making; D030881:Disclosure / Q000941:ethics / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence*; D007872:Legal Guardians / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D012068:Religion and Medicine; D016312:Treatment Refusal / Q000941:ethics / Q000331:legislation & jurisprudence*
keywords: Capacity for treatment decisions; Children’s and adolescents’ consent; Consent to treatment; Guardians’ decisions for dependents; Informed consent/refusal; Pregnant women’s treatment decisions; Refusal of recommended treatment