Isadore Rosenfeld, MD
For any course of treatment that is above routine medical procedures, the physician must disclose as much information as possible so you may make an informed decision about your care. When a patient has been sufficiently informed about the treatment options offered by a physician, the patient has the right to accept or refuse treatment, which includes what a health care provider will and won't do.
If patient competency is questionable, the physician can give the information to a legally appointed guardian or a family member designated by the patient to make decisions for the patient. In addition, there are some patients who do not have the legal ability to say no to treatment. Most patients in the United States have a right to refuse care if the treatment is being recommended for a non-life-threatening illness.
You have probably made this choice without even realizing it. Maybe you didn't fill a prescription, chose not to get a flu shot , or decided to stop using crutches after you sprained an ankle. You may also be tempted to refuse treatment for more emotional reasons. Perhaps you know it will be painful or you are afraid of the side effects. There is nothing illegal about choosing to forgo treatment for any of those reasons.
They are personal choices, even if they aren't always wise choices. Choosing to refuse treatment at the end of life addresses life-extending or life-saving treatment.
It also guaranteed that Americans could choose to refuse life-sustaining treatment at the end of life. When you choose not to be treated, knowing that the refusal will shorten your life, it is usually because you are choosing what you believe will be a better quality of life, rather than a longer life that may be less pleasant.
Some people, knowing they are going to die soon, even choose to end their own lives rather than be faced with decisions that will, in reality, be executed by others. Be aware that if you choose not to receive life-sustaining treatment, it does not mean you are required to forfeit palliative care, which can be administered even for patients who do not want to be kept alive.
Before you decide against receiving treatment at the end of your life, be sure you've followed steps to help you to make that informed decision. You might also consider refusing treatment if you have been diagnosed with a medical problem that requires very expensive treatment. You may prefer not to spend so much money. Patients make this decision when they believe treatment is beyond their means. They decide to forgo treatment instead of draining their bank accounts.
Those who live in a country with a for-profit healthcare system may be forced to choose between their financial health and their physical health. Americans can refuse treatment when they know it will have a negative impact on their finances. Jehovah's Witnesses and Christian Scientists, plus a few non-affiliated churches in different parts of the United States, may be willing to undergo some forms of treatment, but restrict or refuse other forms based on their religious beliefs.
Adults may rely on their church affiliation and its tenets to refuse treatment for themselves if they choose. However, they have less legal standing when it comes to making those choices for their children. Several court cases regarding children with different diseases and medical needs have addressed the legality of refusing treatment based on religious reasons with varying outcomes.
POWER TO THE PATIENT: The Treatments to Insist on When You're Sick
Advance Directives: The best way for a patient to indicate the right to refuse treatment is to have an advance directive, also known as a living will. Most patients who have had any treatments at a hospital have an advance directive or living will. This document is kept on file and tells the treatment team the wishes of the patient in the event that they are unable to speak for themselves regarding their medical care.
Medical Power of Attorney: Another way for a patient's wishes to be honored is for the patient to have a medical power of attorney. This designates a person to make decisions on behalf of the patient in the event they are mentally incompetent or incapable of making the decision for themselves.
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In today's impersonal world of health care conglomerates, receiving the best medical advice isn't always possible. In this cutting-edge guide, Dr. Rosenfeld describes in detail, in plain language, and with his trademark humor, more than 40 of the most common ailments and diseases affecting millions--from acne to cancer, plus such diverse disorders as Parkinson's disease, infertility, gallstones, and diabetes.
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