It is a challenge to provide quality healthcare when patients do not adhere to their physicians’ recommendations for treatment. The patient who insists on leaving the hospital Against Medical Advice (AMA) is an extreme example of non-adherence, and this situation creates high potential for serious errors. Recognition of the reasons patients leave can help negotiate these encounters. They leave for a variety of reasons including personal and financial obligations, breakdown of communication between the patient and medical staff, dissatisfaction in care, and not understanding the need for further testing or treatment. Every effort should be made to determine what is driving the patient’s decision-making process. There may be times when the provider is at a loss to understand why a patient would walk out prior to receiving necessary care. Even in this circumstance, treatment without consent can be deemed as battery, as patients do have the right to refuse care.
Some courts have ruled that it is illegal for a hospital to require a patient to sign a waiver of liability as a “condition of their release” (Dedely V. Kings Highway Hospital Center, 617 NYS 2d 445 Supp (1994)). Therefore, the better approach consists of documenting the following eight criteria:
Documentation proficiency of patients who leave the emergency department against medical advice
“I’m Going Home”: Discharges Against Medical Advice
Take a post-test and get CME credits
Please log in to ObGFirst to access the 2T US Atlas
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
