Psychiatric Consultation When a Patient Refuses Medical Care

Author:

Caravella Rachel A.,Skimming Kathryn,Bradley Mark V.

Abstract

Psychiatry consultants are often called on by colleagues to assess a patient's capacity to refuse medical care. These situations can expand beyond the boundaries of a decision-making capacity question to become clinically, legally, ethically, and emotionally complex situations. This article provides a framework for psychiatrists to navigate these complexities when asked to evaluate a patient for the capacity to refuse medical care. We review decision-making capacity as an element of informed consent in order to clarify the psychiatrist's role in these consults. We discuss related ethical and legal questions that can arise when a patient refuses treatment. This article also addresses other skills beyond decision-making capacity assessment that psychiatrists may utilize to support nonpsychiatrist colleagues and advance the care of the hospitalized patient. [ Psychiatr Ann . 2023;53(1):17–22.]

Publisher

SLACK, Inc.

Subject

Psychiatry and Mental health

Reference22 articles.

1. Assessment of Decision-Making Capacity: Views and Experiences of Consultation Psychiatrists

2. Does This Patient Have Medical Decision-Making Capacity?

3. AMA Code of Medical Ethics. 2.1.1 Informed Consent. In: AMA Principles of Medical Ethics: I, II, V, VIII. American Medical Association. Revised June 2001. https://code-medical-ethics.ama-assn.org/ethics-opinions/informed-consent

4. The Doctrine of Informed Consent Doesn’t Need Modification for Supported Decision Making

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