Page 26 - 2021 Risk Reduction Series - Communication Part One

SVMIC Risk Reduction Series: Communication

• The most likely and severe risks and side effects of the

procedure and treatment or medication, preceded by a
general inclusive statement, such as “including but not

limited to”

• Reasonable alternative methods of treatment or no
treatment, including the risks, benefits, and the prognosis
associated with each alternative or with no treatment

Informed Refusal

The concept of informed refusal is the flip side of informed

consent. Informed refusal acknowledges that every competent
patient has the right to refuse a recommended test, procedure,

or treatment and mandates that the physician or healthcare
provider inform the patient of the risks of that refusal. Another

common form of refusal is the patient who leaves the hospital
against medical advice. The physician, by virtue of the job

definition, may be the only physician involved with informed
refusal, although there were other physicians involved in the

patient’s care. It behooves the physician in this position to be
detailed and accurate both in the explanation of foreseeable

consequences of refusal of treatment and the documentation of
such.

While most people are more familiar with the concept of

informed consent, informed refusal is not an unusual allegation
in medical malpractice litigation. To successfully defend these

cases, there should be clear and documented evidence that
the patient was provided adequate information on the risks of

going without treatment. Both informed consent and informed
refusal are predicated upon the notion that a patient is entitled

to all information necessary to make an informed choice.

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