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March 2007 · Vol. 19, No. 03

MALPRACTICE RISK MANAGEMENT

Protect yourself! Make a plan to obtain “informed refusal”

Always continue the conversation when a patient declines the treatment you’ve recommended


Fast Track

Explain the risks of refusal so the patient can make an informed decision when she declines treatment

A jury concluded that the physician did recommend a CT scan but failed to advise the patient of the risk of not having it

Get informed refusal on the spot if you doubt the patient will return with a decision

James  M.  Goodman,  JD

Partner, Hassard Bonnington LLP, San Francisco, Calif

The concept of informed refusal is similar to that of informed consent. However, in working with physicians for 30 years, I have found that informed refusal is not nearly as well understood as informed consent.

Informed consent means a patient has the right to understand the risks of death, serious bodily injury, or other common outcomes of an operation or medical treatment. The patient also has the right to be told about the risks of refusing a particular operation, test, medication, or other medical intervention.

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