Can a patient refuse sedation? - page 3

by Web-G.I.nurse 18,032 Views | 36 Comments

My G.I. want to use Versed for a long colonoscopy. Even tho my last colonoscopy was painful,i don't think i want to be sedated with weird meds.... Read More


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    I have to say that i have had many different investigations, flex sig and colonoscopy included and nothing prepared me for the pain that came with them....esp the flex sig which was w/o sedation. I have since been told if you have inflammation you have more chance of being in pain - which I have:-(
    I could not force myself to go thru that again without proper meds. I'm in awe of anyone that can tolerate this procedure w/o anything to dampen the pain.
    darne20 likes this.
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    I guess people have to decide for themselves what they want to do. I was just commenting that for myself, having had both upper and lower, both were easy with a little sedation. I watched my lower scope on the screen and that was neat but I was totally asleep for the upper endo. No ill effects. I guess I am lucky that I have never had any kind of negative response to any type of sedative medication and my GI doc uses pediatric size scopes.
    darne20 likes this.
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    Well, now, there is a difference between having no sedation and having no analgesia! I have nothing for my upper endoscopies but we do use some demerol for the colonoscopy as we tend to have some difficulties w/my transverse colon just before the hepatic flexure that can get uncomfortable. Just enough demerol to take the edge off and keep the discomfort bearable whilst "we" work "our" way past that point. And it can get uncomfortable at the ileocecal valve as well so I'm NOT a masochist! I just don't want to be sedated so that I can't watch the monitor and remember what I saw!!!
    darne20 likes this.
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    ChronieToo-I couldn't agree with you more. Sedation and analgesia are often used interchangeably, but in fact many people have negative experiences with sedation (especially Versed), but they can have a comfortable procedure with just an analgesic (fentanyl).
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    I "refused" actually declined sedation for my colonoscopy last week. It didn;t hurt at all
    backscatter likes this.
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    A patient cannot be mandated to take any treatment or medication against their will unless:
    1. They are ordered via the courts to do so.
    2. The have a power of attorney decision maker for health care that can make those decisions for them.
    3. If a critical condition exists that, in the opinion of at least two physicians, will result in loss of life or limb if not treated and the patient at the time does not have the mental capacity to make the decision for him/ herself.
    4. If the person is a minor child and is a suspected victim of abuse. In my experience we called CPS (children's protective services) and a judge. The judge mandated that the child be removed from the custody of the parent/ guardian immediately and we proceeded with the emergency procedure required.

    This is a very sticky area depending on the state law where you live, the mental health law for your state and your hospital policy. But as a general rule, if you are an adult, awake, alert, oriented and not under the influence of a mind altering substance you have the right to refuse any or all medical care or procedures even if it will result in harm to you. People have the right to make a stupid decision.
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    More and more patients are declining sedation for endoscopy and that's their absolute right. The endoscopist can refuse to do the exam unsdated, but he/she had better have a good reason for doing so..not just the usual "it's going to hurt".....If you absolutely don't want sedation, don't sign the sedation consent or cross out references to sedation in the general procedural consent.
  9. 0
    I had a sigmoidoscopy in the doctor's office, w/o sedation. NEVER AGAIN. It was extremely painful, I almost passed out afterward. I have also had a colonoscopy w/sedation, and no problems. No, that's not correct, I was given morphine (I would vomit for hours after Demerol). Then I vomited till 5am.

    They know now to give me Fentanyl and I have no problem with Versed.
  10. 0
    I've only had one sigmoidoscopy. It was quite an .... experience. It was done at Mayo Clinic in Rochester, Minnesota back in early 1976. I had NO idea back then what I was getting into!!! I stripped to a gown and my socks. A nurse instructed me to kneel on this church pew like contraption w/a tray or table for me to place my elbows. Then the doctor came in, the pew tipped down and my butt went up in the air. The sigmoidoscope was inserted. I had no pain and the only discomfort was my dread that I was going to expel a good bit of air directly into the doctor's face!!!!

    Knowing what I do now I appreciate that "pew" and being turned upside down as I'm sure that helps to straighten out the sigmoid colon and reduce the discomfort of the scope and as expected at Mayo the doctor was experienced and skilled and didn't get carried away with inserting air into the colon.

    And I'm pretty sure back then they didn't have the flexible sigomoidoscopes like they do now and that it was a rigid sigmoidoscope.


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