Question

Discuss the patient's right to terminate care with a health care professional. Identify the steps a patient would take to terminate care. Explain the ethical components that would take place in that process.

Answer 1

Patient's right to terminate care

As per law, competent patients are allowed to refuse treatment even if the treatment is seen to be medically necessary.This indicate every individual have the right to choose what will be done to their own body, and it applies even when refusing treatment means that the person may die. In any instance the patients have the moral and legal right to determine what will be done with their own treatment plan. This is universally recognized as a fundamental principle of liberty.

The healthcare professionals have to be given accurate, complete, and understandable information in a manner that facilitates an informed judgment. Also assis with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment. Help them to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or penalty. And to be given necessary support throughout the decision-making and treatment process. Patients should be involved in planning their own health care to the extent they are able and they have the right to take ultimate decision on their course of treatment.

The steps a patient would take to terminate care.

There are five basic steps in refusal of treatment

• The patient must understand sufficient information about his or her medical condition and plan of treatment and also the available alternatives. Discuss the condition with care provider in detail.
• The patient must understand the risks and benefits of available options, including the option not to act. That means before taking the decision on treatment refusal patient must understand all pros and cons it
• The patient must use the above information to make a decision in keeping with his or her personal values. This indicate the use of cognitive reasoning capacity, the patient should analyze all the aspects of treatment plan with sound mind.
• The patient have to execute the freedom of will to act without undue influence from other parties, including family and friends
• Then the patient must be communicate his or her choices to treating Doctor/ nurse. This has to be done by patient by himself. Not allow others to take decision on his or her behalf.
• Finally after taking the decision to refuse treatment the patient has to give written refusal consent that denotes he/ she taken that decision after understanding all the consequences and benefits. this should be signed by patient as well as by witness as per the Hospital/ government policy

Informed refusal, just like informed consent, comprises three elements:

1. He or she must have sufficient information to be able to make a choice.
2. The patient must be competent.
3. The decision must be made voluntarily.

Ethical components of patient's right to terminate care

Patients' rights formalized in 1948, the Universal Declaration of Human Rights recognizes “the inherent dignity” and the “equal and unalienable rights of all members of the human family”.The patient's right to autonomy should always be respected and steps shall be taken to make consent truly informed. There is, however, no absolute right to consent on the basis of philosophical, ethical, legal and practical considerations.

Ethical issues are arising in some refusals like When should physicians end lifesaving treatments? How can we balance pain relief? We now have more technologies that allow us to prolong life, and patients families and society therefore demand these treatments in the wish to “do everything.” In such cases refusal from patient side will definetly cause mental dilemma in healthcare providers.

This has two sides. no one should compel a patient on their treatment choice, some treatments like blood transfusion will not be accepatable for some religions. hurting this believes is not ethical in the sense. At the same time, if the patient die or enter in more serious complication due to refusal of treatment calso cause an ethical issue. Refusal of treatment not always works in relay with ethics of the society.