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Case 7

Answer

Does Ms Wong's imploring attitude constitute impermissible coercion of the patient?

NO.

Did Ms Wong breach the patient's right of autonomy to refuse treatment?

Pg45. Not under the circumstances of this hypothetical example. Ms Wong had the legal duty to use her persuasive powers to attempt to convince the patient that the proposed intervention was in the patient's best health interest. In this case, rather than making a knowing, intelligent, voluntary and unequivocal to decline care, the patient assented to the intervention by her conduct. Ms Wong, practicing beneficence, fully respected the patient's autonomy right of veto power over the proposed intervention.

What should Ms Wong do, if after reiteration and imploring, the patient decline evaluation and therapy?

Informed refusal of care (pg44-45):
After being informed of the nature of a proposed intervention, material risks of harm or complication associated with that intervention, the nature, risks, and benefits of reasonable alternatives to the proposed intervention, and goals of treatment, the patient refuses care, additional steps must be taken by the PT to protect the patient and minimize the risk of malpractice liability exposure. Specifically the following must be done:

  • Reiterate information disclosure points for the patient/parent.
  • Solicit additional questions or comments about the proposed or other interventions from the patient / parent.
  • If patient persists in refusing the proposed or another appropriate intervention, do not proceed with the intervention.
  • Document the informed consent/refusal processes succinctly in the patient's medical treatment record.
  • Expeditiously alert any referring agent and /or appropriate health care team members about the patient/parent's refusal of intervention.

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