A patient’s refusal to undergo medical treatment has always been a contentious subject in medicine. The patient’s right to refuse the provided treatment is guarded by numerous statutes and amendments, such as (Lynch, 2016):
- The 1st Amendment (section regarding free speech) protects the patient’s thoughts and ideas;
- The 1st amendment (section regarding religious freedom) protects the refusal of treatment on the grounds of personal religious beliefs;
- The 8th Amendment allows perceiving unwanted treatment as cruel and unusual punishment;
- The 14th amendment protects the patient’s liberty and personal security, which are violated if a treatment is administered against consent;
- The right to privacy can be interpreted in a way to refuse treatment.
Therefore, if a patient refuses treatment based on his or her religious beliefs, they are acceptable and entitled to 1st Amendment protection. However, there are some exceptions to the rule. Namely, religious beliefs can be overlooked if the patient is considered to be mentally unstable and incapable of making informed decisions. Secondly, religious authority is very limited when taking decisions for underaged patients. Lastly, religious beliefs can be ignored if they are considered a credible threat for the rest of the society.
The first part of the process of granting the refusal request made by a patient is to evaluate their words based on the three factors stated above. In patients with mental illnesses such as Alzheimer’s syndrome, dementia, schizophrenia, and other mind-altering diseases, religious beliefs do not constitute a viable reason to refuse treatment, as the patient in question cannot adequately evaluate their own options (Applebaum, 2007). Should it be concluded that the patient is in sound mind and their religious beliefs do not endanger the rights and lives of everyone else, the nurse should conversate with the patient in order to discover the reasons behind the religious rejection of certain practices while offering feasible alternatives, if possible. Should these attempts be ignored as well, the nurse is expected to work with the patient in order to determine acceptable boundaries in which healthcare providers could operate. For example, if an individual refuses treatment that would prolong their life, they could still accept medication to relieve pain and make the process of passing easier.
After life-sustaining treatment is forgone, medical specialists in question are supposed to file a medical record, which would feature the physician’s notes and information regarding the diagnosis and prognosis for the patient, as well as the current and potential treatment plans, consulting opinions, and other factors that led to the decision made by the patient (Ahaddour, Van den Branden, & Broeckaert, 2018). In addition, the nurse would have to make a statement regarding the patient’s decision-making capability. In case the patient is unable to make the decision, it should be forwarded to a surrogate decision-maker. Alternatively, a legal clause must be cited in order to justify foregoing treatment.
Lastly, a written order should be attached to the record in order to effectuate and validate the decision (Ahaddour et al., 2018). The overall procedure should be conducted in accordance with the healthcare facility’s instructions and policies. Should all of these requirements be met, then the nurse is allowed to grant the treatment refusal request. However, as it is often shown in practice, every situation of treatment refusal is atypical to the others, with numerous physical and psychological aspects coming into play. In many cases, a decision by the bioethics committee is necessary to facilitate the action in order to guard the patient’s best interests.
References
Ahaddour, C., Van den Branden, S., & Broeckaert, B. (2018). Between quality of life and hope. Attitudes and beliefs of Muslim women toward withholding and withdrawing life-sustaining treatments. Medicine, Health Care and Philosophy, 21(3), 347-361.
Applebaum, P. S. (2007). Assessment of patient’s competence to consent to treatment. The New England Journal of Medicine, 357(18), 1834-1840.
Lynch, J. (2016). Consent to treatment. New York, NY: CRC Press.