Can a patient refuse sedation?

Trauma Columnist · Feb 15, 2009

A patient can refuse any and all procedures/meds/treatments they want.

CrohnieToo · Feb 23, 2009

But keep in mind the doctor can also refuse to do the procedure so its best to hash it out and get things out in the open before hand.

flightnurse2b, LPN · Feb 23, 2009

you can refuse anything you want to refuse, thats your right!

like crohnie said tho, some doctors may not want to do the procedure without you being sedated. you may want to discuss your options with them beforehand.

truern · Feb 23, 2009

Am I ever feeling like a woose!! I had propofol for my colonoscopy!!

CrohnieToo · Feb 24, 2009

No need to feel like a woose!!! The important things is to have our colonoscopies as needed and recommended! Whether we are a woose or a masochist or somewhere in between has absolutely no bearing. Just have those scopes as needed!!!

Now, if you wanna talk about those darn preps before a colonoscopy ......:angryfire:icon_roll:bugeyes: :uhoh3: :bowingpur

allnurses Guide · Feb 25, 2009

I had a flexible sigmoidoscopy without anesthesia.

Last time for a colonoscopy the MD suggested a CRNA. I paid an extra $100.00 because insurance didn't approve it.

I am glad because I want a competent RN without any other duty for conscious sedation.

It is YOUR choice. The same as for all patients.

darne20 · Mar 14, 2009

Absolutely, but as stated, the doc can decline to do the procedure. I get yearly colonoscopies and after one absolutely horrible experience with Versed (Midazolam), I would never consent to that drug again. The long-term memory loss and the depression has to be experienced to be believed. About 90% of patients have a decent experience with Versed; but 10% do not. Most patients leave the endoscopy suite in a semi-daze and appear to be content; in about 10% the nightmares etc. start later. I used to think that the horror stories about Versed (askapatient.com or versedbusters) were a little exaggerated, but I have never heard of a drug that was so hated to have it's own website. My degree is in clinical pharmacology; I believe that patients who are properly consented beforehand by a nurse (ie: this drug is being given so you will forget the procedure, not: this drug is to make you comfy) will, for the most part, do o.k. with Versed. I was not properly consented, and even though I know a lot about benzodiazepines and GABA-A receptor theory, the creepy amnesia from Versed haunted me for a long time before I figured out what was wrong. Even now, facing painful elbow and wrist surgery on both arms, I'm sure that I will consent only to a Bier Block without any sedation whatsoever. Sure, discuss your options with the GI doc beforehand; any reasonable doc will let you skip Versed, if you need something for pain consider Fentanyl only. But I hate to say it, most GI docs like an amnesic patient and only see the patient immediately after the procedure and the problems start later. My last 2 colonoscopies were with nothing; each time I was ready for them to try to talk me into conscious sedation..when I mentioned problems with Versed, the doc agreed immediately and she told me that they had a lot of patients complain about it and that she would not consent to receiving it herself. I had my latest colonoscopy at the hospital where I work an I made sure that everyone knew my low opinion of Versed and the doc assured me that I would not get it. I was surprized when they had a problem with me declining the IV (I wanted to make sure that there were no screw-ups); the nurse who wanted to start the IV was a CRNA; my doc had called her in so that I could get Propofol instead of Versed. When I declined Propofol, the CRNA told me that there was no extra charge for her services (as a courtesy since my first exam was a disaster and I was given Versed even though it was a listed allergy. She was somewhat disappointed that I no longer trust sedation of any kind; all of this could have been avoided if a nurse was available to do informed consent for the first procedure-never let economics or scheduling remove your professional nursing skills from the process-you are essential to patient safety. Interestingly enough, the CRNA told me that she would also decline Versed and that she almost never uses it. Unfortunately, I doubt that I will ever consent to any type of sedation, no matter ho painful the procedure. And I know better; a bad experience with Versed can do that to you, even if you have a Ph.D. Just make sure that you get real informed consent before and type of mind-altering drugs are administered.

neveragain · Apr 6, 2009

In theory the patient is allowed to have some say over sedation drugs or anything else for that matter. In practice it's not true. My nurse never said a word even though she knew that I had declined the drugs and had not signed an informed consent for same. I think she was intimidated (?) by the CRNA and the Doctor.

CrohnieToo · Apr 6, 2009

Yes, you can. However, it is only fair that you advise your doctor well before the procedure that you will not accept sedation. Understand that your refusing sedation whether days prior to the procedure or immediately prior to the procedure, your doctor also has the option of refusing to do the procedure w/o sedation. That is why it is best to discuss the matter well before hand so the two of you come to a meeting of the minds.

neveragain · Apr 6, 2009

I refused the procedure if I had to be sedated or knocked out. I told the doctor, called his office to remind him the day before surgery and told everybody that came in my room at the hospital that these things were out of the question. It didn't make any difference. They say I gave permission for the general anesthetic after I was heavily sedated (also against my stated desires) by "not objecting." Since I really couldn't move or speak at the time, this was very bad. Medical procedures are a necessary part of our lives, but be aware that patient rights are not written in stone and breaching them has no consequences. My Doctor and I did discuss this at length and I had to pay $250 to tell him all of this. He never said anything to the contrary. The people in the hospital never said anything to contradict what I told them, they just went right on ahead. The head nurse at the next hospital I went to to repair the damage from the first argued with me over the sedation. I had to tell her that it was a deal breaker to do my procedure with Versed or general anesthetic. I got the procedure done with Fentanyl (for the tourniquet pain), a beir block and nausuea meds. This is exactly how I wanted it done in the first place. I am not saying all this to be argumentative, but for information. I had a false sense of security when I went in the first time. Obviously I was on a different page than the first group. At no time was I informed that they had a completely different plan from the one I had accepted the risk for. Just be careful. Not everybody is a scrupulous as the people here.

serialmom12 · Apr 6, 2009

Yes you can refuse sedation. Just talk to your doctor before the procedure and make sure that he/she will do the procedure w/o sedation, don't let it be a last minute surprise. I always am up front with my refusal of sedation, and I've always been lucky enough to find compassionate Dr's and Dentists that have always honored my wishes. If they refuse to do so, RUN LIKE HELL and find another doctor. I always think that if they insist on sedating you, especially for something that isn't really a painful procedure (like a colonoscopy or tooth extraction...yes I've had both, several times w/o sedation, and it always turned out fine) that they're being sneaky and devious and just trying to get extra money for the procedure....don't go to these idiots, spread the word about them and ALWAYS refuse the drug Versed/Midazolam if they try to sedate you. It's dangerous, the GOOD and caring doctors know this and refuse to used it on their patients...thank GOD. If you feel you must be sedated, insist that they use Propofol on you, while it's not the perfect choice, at least you're under and out of it very quickly with few side effects. Versed causes permanent damage in a good number of patients, and you're left with PTSD, severe anxiety and memory loss (speaking from experience.)