Capable Patient/Client Refusing Plan of Care
Capable Patient/Client Refusing Plan of Care
Patients/ clients are considered capable unless proven otherwise. They have the right to refuse any treatment/ procedure being proposed and to revoke any consent previously given to any or all aspects of their plan of care. Sometimes their decisions are not what the healthcare team has determined to be the best course of action. However, the patient/client’s wishes must be respected; unless the practitioner has reasonable grounds to determine that patient/client lacks the requisite capacity to consent.
An Oxygen discharge assessment is performed and the RT informs the patient/client that they have qualified for home oxygen, which has been clinically proven to be beneficial for the individual’s medical condition. However, the patient/client states that they do not need it and refuses the referral for home oxygen. How should the RT proceed?
The ethical principles involved in this scenario include respect for the patient/client’s free will, which conflicts with the RTs need to do good.
The RT must ensure that the patient/client is fully informed of the risks of their decision but ultimately must respect the capable patient/client’s decision. The ordering physician needs to be informed of the individual’s decision as well as any other affected parties (e.g., patient/clients nurse). In addition, the conversation with the patient/client should be carefully documented.
For more information on consent and the capacity to consent, please see the CRTO Responsibilities Under Consent Legislation PPG at: www.crto.on.ca/pdf/PPG/UnderConsent.pdf