refusal of treatment

  1. if a patient has rights to refuse treatment of any kind, do you think they should be able to refuse a special diet. maybe salt free, dys 1, 1600 cal reducing, or diabetic diets. whatever. tell me your opinion.
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  2. Poll: do you think pts. should be able to refuse to be put on special diets?

    • yes

      85.71% 54
    • no

      14.29% 9
    63 Votes
  3. 22 Comments

  4. by   Sleepyeyes
    They have the "right" but their noncompliance should be investigated and documented as such.
  5. by   ageless
    Of course patients have a right to non-compliance of diet as well as any other treatment modality. Document patient teaching and whether the patient/family communicates understanding before documenting non-compliance.
  6. by   TIREDmidnightRN
    That isn't as simple as it sounds. They surely have a right to refuse anything we DO TO or FOR them.....but do they have a right to demand that WE HARM THEM? I mean, if the client is diabetic and running CBG's in the 400's, does he have the right to demand that WE serve him the same diet as his roommate (ya know that tray with the frosted carrot cake)?
    I do not think so. We should serve what is ordered, and not interfere (other than carefull documentation) when family brings in that cake!
  7. by   canoehead
    I think that if the pt wants something we can't in good conscience give them then they need to get it for themselves- unless on an end of life pathway, or perhaps negotiated treats.
  8. by   ageless
    I do not think a nurse should make him or herself an accomplice to a non-compliant act such as giving the patient their heart's desire by ignoring diet restrictions. This would definately negate any teaching that was done prior to the act. Patients, some with the help of their family, have a way of smuggling anything they choose into their mouths. I had one renal patient who would put his mouth right up to the faucet to gulp down water by the liter. I did not help him get to the sink, but caught him in the act. I calmly re-enforced my patient teaching, documented what I had seen, what I my intervention was at the time, and the patient/family response to the re-enforced instructions. The fact that I had documented my teaching many times prior to the infractions saved my butt when the renal doc was screaming in the hallway about his fluid over-load. The patient has the right to refuse any treatment modality and I have the right to protect myself from the repercussions of willful actions. I will not help him harm himself, but I can not punish or wrestle him and his "well meaning" family to the ground either.
    Last edit by ageless on May 5, '02
  9. by   Cubby
    We have many non-compliant residents. It is a problem of astronomical proportions in my facility (we have 301 residents).
    No you don't have to serve them what they want, give them the diet that is ordered,but they don't have to eat it!!! Even when it is detrimental to their health they still have the right to refuse what the Dr. ordered.DOCUMENTATION!!!!! The only time you have the right to force any patient/resident is if they have been declared incompetent by the courts to refuse treatment.Then they have to do what the Dr or any other modalities prescribe.
  10. by   TIREDmidnightRN
    I once had a house doctor demand that I inform a client's family that they were abusing the patient by providing him with snacks as he demanded.(I can see his point here) ... He even wanted me to bar the visitors entrance to the room, because the client had an out of control blood sugar!
    I let the supervisor deal with the doctor on that one!
  11. by   live4today
    Originally posted by tiger
    if a patient has rights to refuse treatment of any kind, do you think they should be able to refuse a special diet. maybe salt free, dys 1, 1600 cal reducing, or diabetic diets. whatever. tell me your opinion.

    Patients most certainly do have a right to refuse whatever treatment they aren't willing to acknowledge being necessary or desired for their well being, HOWEVER, that's when the patient needs to be asked to sign a documentation that they were educated on the facts of what could happen to them by their refusing to be compliant with any given treatment plan, then DISCHARGE them to home to continue living out the rest of their life as THEY SO DESIRE! That's when I would say to them, Adios, and have a nice life!
  12. by   shay
    Originally posted by cheerfuldoer

    Patients most certainly do have a right to refuse whatever treatment they aren't willing to acknowledge being necessary or desired for their well being, HOWEVER, that's when the patient needs to be asked to sign a documentation that they were educated on the facts of what could happen to them by their refusing to be compliant with any given treatment plan, then DISCHARGE them to home to continue living out the rest of their life as THEY SO DESIRE! That's when I would say to them, Adios, and have a nice life!
    I agree with THIS statement. I think that yes, they certainly have the right to refuse treatment, but by God, if you're gonna totally refuse/undo everything we try to do for you, then buh-bye. Go kill yourself at home and quit taking up bed space.
  13. by   fedupnurse
    Sure they can refuse. But they should ahve to sign a document as stated above and if they continue to live in an unhealthy way, their insurance companies should hike up their rates significantly. Refusing to insure people leads to them freeloading off the system, so make them pay for their evil ways.
  14. by   mamabear
    I agree wholeheartedly with sleepyeyes and fedupnurse. Pts do have the right to refuse any and all therapeutic interventions BUT they should sign a waiver, and the nurse(s) involved should document, document, document!!
  15. by   nursedawn67
    Yes...but document document document!!!!

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