What is the recommended approach when a patient refuses treatment?

• A. Dismiss the patient from care
• B. Respect autonomy, document informed refusal, discuss risks/benefits, involve the patient
• C. Force treatment
• D. Document refusal but proceed anyway

Answer: (B)

Respecting patient autonomy is the guiding principle when someone refuses treatment. If the patient has decision-making capacity, acknowledge their right to decline and ensure they understand what refusing means. Discuss the risks and benefits of both accepting and declining the treatment, answer questions, and involve them in the decision-making process. Then clearly document that the patient was informed, the nature of the discussion, and the refusal in the chart. If the patient cannot make an informed decision, involve a legally authorized representative or follow your facility's policies for surrogate decision-making. Coercion or proceeding with treatment against the patient’s wishes is not appropriate, except in rare emergencies where urgent care is needed and no surrogate is available.