The four goals of medical treatment include:
PreventiveCurativeManagementPalliative
Whether a treatment falls under these goals of care depends on what condition you have. It also depends on what is most important to you—for example, quantity versus quality of life.
Unfortunately, sometimes the choices available won’t offer the outcomes you prefer. Therefore, your right to refuse care often depends on your circumstances and why you choose to decline care.
This article explains informed consent and various situations that allow for the refusal of medical care. It also covers exceptions for refusing medical care.
Before a healthcare provider can begin any course of treatment, they must make you aware of what they plan to do. That means they must disclose as much information as possible so you can make an informed decision about your care.
When a healthcare provider sufficiently informs you about the treatment options, you have the right to accept or refuse treatment.
It is unethical to physically force or coerce someone into treatment against their will if they are of sound mind and are mentally capable of making an informed decision.
In addition, some people do not have the legal ability to say no to treatment. Even in non-emergency situations, some people can not refuse medical treatment.
Mental Capacity
People may not have the right to refuse treatment if they have an altered mental state. Altered mental capacity may be due to alcohol and drugs, brain injury, or psychiatric illness.
Children
A parent or guardian may not refuse life-sustaining treatment or deny medical care for a child—not even if their religious beliefs discourage specific medical treatments. That means parents cannot invoke their right to religious freedom to refuse treatment for a child.
Threat to the Community
A person’s refusal of medical treatment cannot threaten the community. For example, infectious diseases might require treatment or isolation to prevent spreading to the general public. Another example is when someone poses a physical threat to themself or others.
You may also be tempted to refuse treatment for more emotional reasons. For example, perhaps you know it will be painful, or you are afraid of the side effects.
Either way, there is nothing illegal about choosing to forgo treatment for any reason. They are personal choices, even if they aren’t always wise choices.
The PSDA also mandated nursing homes, home health agencies, and HMOs to provide patients with information regarding advance directives, including:
Do not resuscitate (DNR) orders Living wills Physician’s orders for life-sustaining treatment (POLST)
Some people do not want decisions about their care to eventually be decided by someone else when they can no longer make decisions for themselves. So, they may set up advance directives ahead of time that state their wishes.
When people refuse end-of-life care, they often want a better quality of life rather than a longer life that may be less pleasant.
Palliative Care
Declining life-sustaining treatment does not mean you are required to forfeit palliative care.
This type of care can be administered even for patients who do not want to be kept alive.
Before you decide against receiving treatment at the end of your life, be sure you’ve followed steps to help you make an informed decision. Writing out your wishes can help ensure that those caring for you follow your plans.
Therefore, sometimes people refuse treatment when it is beyond their means. So, they forgo treatment to avoid going into debt over high medical bills.
Adults may rely on their religion and its tenets to refuse treatment if they choose. However, they have less legal standing when making those choices for their children.
First, work through your options with a professional, such as a patient advocate, who is committed to shared decision-making. The shared decision-making process helps you weigh your values and beliefs against your options to make the best choice for you.
Next, be sure you are allowed to refuse medical treatment and that you are not in a category where refusal is restricted.
Finally, make it formal by drawing up an advance directive and medical power of attorney.
Advance Directives
The best way to indicate the right to refuse treatment is to have an advance directive. This document is also known as a living will.
Advance directives are kept on file with a hospital. They tell the treatment team what your wishes are if you are unable to accept or refuse medical care (like if you were unconscious or dying).
Medical Power of Attorney
Another way for your wishes to be honored is to have a medical power of attorney. This document designates a person who can make decisions on your behalf if you are mentally incompetent or otherwise can’t make the decision for yourself.
For example, if someone requires emergency life-saving treatments, if they do not have the mental capacity to do so, or they are a threat to the community. In addition, parents may not deny life-sustaining treatment for their children.
A Word From Verywell
Making plans about medical treatment can be overwhelming and confusing. So if you are facing these choices, it’s a good idea to get professional support. First, find a doctor who values shared decision-making. Then, obtain legal counsel to draw up an advance directive and medical power of attorney documents. These steps can help ensure that your wishes are honored and offer peace of mind.
