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A physician has the responsibility of explaining to the patient the benefits, risks, and alternatives so as to enable the patient to make informed decisions or give informed consent. The nurse has the duty of acting as the patient’s advocate and playing a key role in getting patients consider the consequences or alternatives of refusing or accepting care (Weingart et al 2009). The nurse ought to document all efforts to give the patient the necessary information to decide to accept or refuse care. Documentation, thus, ought to be objective including information such as the date, time, who spoke with the patient, the content of what the information that the patient was given, the comments that the patient made, and the final disposition. Documentation of details such as telephone numbers, names, and referrals made by the nurse should be given to the patient on discharge with a listing or description of any instructions given verbally or preprinted forms (Pennycook et al 2011). Proper documentation would be done in the body of the chart of the patient. Other elements to be documented would be their capacity for decision-making, the decision of the patient, the risks that were revealed, the patient’s understanding of the risks, and the signatures of both the physician and the patient. It is advisable to use a comprehensive AMA form to increase proper documentation. Emergency physicians ought to do an assessment of the AMA form to ensure that it is adequate, and in cases where a patient declines to sign the AMA form, the physician is expected to read it aloud, keep a documentation of refusal to sign including the fact that the patient was made aware of the risks of leaving (Schaefer, 2012). With the prevalence of against medical advice medical discharges and the severe problems that they present, physicians of emergency departments always make attempts to prevent patients from leaving against medical advice, but when it is unavoidable, three requirements are normally expected to be met so that the AMA process can grant optimal legal protection; the patient should be considered to have the capacity to refuse care, a disclosure of all potential risks to the patient, and the against medical advice consent be documented properly in the chart (Brown, 2012). Since the law dictates the patient’s right to refusal of medical care, and since treatment without consent could be considered battery, at the point where a patient signs out AMA, they are exercising this right of refusing medical care. Should it be determined that the patient is incapable of making the decision, then it will be unethical and illegal for the physician to allow a discharge that could lead to imperiling the life and health of the patient. In as much as a patient has the legal right to refuse medical care, the exercising of this right is solely dependent of the patient’s capacity of decision-making. A formal assessment would normally be done on the patient to determine their decision-making capacity (Brown, 2012). The ethical obligation of disclosure of all risks associated with the patient’s leaving AMA is a secondary tool and requirement for risk management. It is also worth-noting that the appearance of the patient’s signature on the AMA form does not necessarily give a ...Show more


AMA Leaving Against Medical Advice There is prevalence of patients leaving a medical care environment against medical advice and either preliminary treatment or continuing treatment bring about concerns form legal, ethical , and medical points of view…
Author : jerroldhackett
AMA2.2ETHDB essay example
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