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Journal articles on the topic 'Refusal of medical care'

Author: Grafiati

Published: 4 June 2025

Last updated: 1 August 2025

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1

Downie, Jocelyn, and Matthew J. Bowes. "Refusing care as a legal pathway to medical assistance in dying." Canadian Journal of Bioethics 2, no. 2 (2019): 73–82. http://dx.doi.org/10.7202/1062304ar.

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Can a competent individual refuse care in order to make their natural death reasonably foreseeable in order to qualify for medical assistance in dying (MAiD)? Consider a competent patient with left-side paralysis following a right brain stroke who is not expected to die for many years; normally his cause of death would not be predictable. However, he refuses regular turning, so his physician can predict that pressure ulcers will develop, leading to infection for which he will refuse treatment and consequently die. Is he now eligible for MAiD? Consider a competent patient with spinal stenosis (

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2

Groenhout, Ruth. "Reformed Theology and Conscientious Refusal of Medical Treatment." Christian bioethics: Non-Ecumenical Studies in Medical Morality 26, no. 1 (2020): 56–80. http://dx.doi.org/10.1093/cb/cbaa001.

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Abstract Traditionally, healthcare workers have had the right to refuse to participate in abortions or physician-assisted suicide, but more recently there has been a movement in white Evangelical circles to expand these rights to include the refusal of any treatment at all to same-sex couples or their children, transgender individuals, or others who offend the provider’s moral sensibilities. Religious freedom of conscience exists in an uneasy tension with laws protecting equal rights in a liberal polity, and it is a particularly fraught question in the context of medicine, where providers’ con

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Ziebart, David. "JEHOVAH’S WITNESSES – MEDICAL CARE, MINORS AND THE RELIGIOUS RITE/RIGHT." Denning Law Journal 19, no. 1 (2012): 219–47. http://dx.doi.org/10.5750/dlj.v19i1.384.

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Responsible and caring parents seek the best possible medical care for their children. In the case of parents who are Jehovah’s Witnesses their religious beliefs prohibit medical intervention which uses blood. This prohibition specifically includes the refusal of blood transfusions even where such a refusal may result in the death of the person concerned. Jehovah’s Witnesses as a result are often viewed with animosity or contempt, considered foolhardy and recklessly disregarding life, martyring themselves and their children. This article seeks to examine the religious origins of the blood proh

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REID, WILLIAM H. "Pregnant Patients’ Refusal of Medical Care." Journal of Psychiatric Practice 7, no. 2 (2001): 141–44. http://dx.doi.org/10.1097/00131746-200103000-00008.

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5

Ninise, Ezile Julie, Busisiwe Mrara, and Olanrewaju Oladimeji. "Causes and Outcomes of Intensive Care Admission Refusals: A Retrospective Audit from a Rural Teaching Hospital in Eastern Cape, South Africa." Clinics and Practice 13, no. 4 (2023): 731–42. http://dx.doi.org/10.3390/clinpract13040066.

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(1) Background: Patients who deserve intensive care unit (ICU) admission may be denied due to a lack of resources, complicating ICU triage decisions for intensive care unit (ICU) clinicians. Among the resources that may be unavailable are trained personnel and monitored beds. In South Africa, the distribution of healthcare resources is reflected in the availability of ICU beds, with more ICU beds available in more affluent areas. Data on ICU refusal rates, reasons for refusal, patient characteristics, and outcomes are scarce in resource-constrained rural settings. Hence, this study sheds light

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McDonald, Cary C., Max D. Koenigsberg, and Sharon Ward. "Medical Control of Mass Gatherings: Can Paramedics Perform Without Physicians On-site?" Prehospital and Disaster Medicine 8, no. 4 (1993): 327–31. http://dx.doi.org/10.1017/s1049023x00040590.

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AbstractObjective:Evaluate the experience of paramedic personnel at mass gatherings in the absence of on-site physicians.Design:Retrospective review of patients evaluated by paramedics with emergency medical services (EMS) medical control.Setting:First-aid facility operated by paramedics at an outdoor amphitheater involving 32 (predominantly rock music) concerts in accordance with the Chicago EMS System, June through September 1990.Participants:A total of 438 patients (≤0.1% on-site population) were evaluated.Interventions:Presentations to the first-aid facility were viewed as if the patient w

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7

Shashidhara, Shilpa. "Commentary: Looking beyond Treatment Refusal." Cambridge Quarterly of Healthcare Ethics 25, no. 2 (2016): 333–36. http://dx.doi.org/10.1017/s096318011500064x.

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This case illustrates the dilemma that occurs when a patient refuses treatment. When a patient refuses recommended interventions, it can cause much distress among the medical team and family. On the surface, the ethical issue appears to be in regard to treatment refusal. However, when we look deeper, it becomes evident that the question is truly about whether the patient has the ability to make this treatment decision, given her worsening dementia, recent hemorrhage, and depression. In this case, an essential component of an ethics consultation would be to assess this patient’s decisionmaking

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Tsyganova, Olga A. "Providing medical care without patient or legal representative’s consent, and patient refusal of medical intervention: regulatory framework and legal practice." Russian Family Doctor 28, no. 4 (2024): 16–23. https://doi.org/10.17816/rfd633443.

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This lecture focuses on the regulatory framework and legal practices regarding provision of medical care without the consent of the patient or their legal representative. It discusses the grounds for delivering medical care in the absence of consent and provides a procedural algorithm for healthcare professionals to follow in such situations, as well as in cases where a patient refuses medical intervention. The lecture also highlights the documentation requirements for instances of medical care provided without consent and cases of patient (or legal representative) refusal of medical intervent

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Apenteng, Patricia, Saverio Virdone, John Camm, et al. "Determinants and clinical outcomes of patients who refused anticoagulation: findings from the global GARFIELD-AF registry." Open Heart 10, no. 1 (2023): e002275. http://dx.doi.org/10.1136/openhrt-2023-002275.

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ObjectiveThere is a substantial incidence of stroke in patients with atrial fibrillation (AF) not receiving anticoagulation. The reasons for not receiving anticoagulation are generally attributed to clinician’s choice, however, a proportion of AF patients refuse anticoagulation. The aim of our study was to investigate factors associated with patient refusal of anticoagulation and the clinical outcomes in these patients.MethodsOur study population comprised patients in the Global Anticoagulant Registry in the FIELD (GARFIELD-AF) registry with CHA2DS2-VASc≥2. A logistic regression was developed

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Dudzinski, Denise M., and Sarah E. Shannon. "Competent Patients’ Refusal of Nursing Care." Nursing Ethics 13, no. 6 (2006): 608–21. http://dx.doi.org/10.1177/0969733006069696.

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Competent patients’ refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: lack of paradigm cases, social taboo around unmanaged incontinence, the distinction between ordinary versus extraordinary care, and the moral distress experienced by nurses. We examined this case on the merits and limitations of five well-known ethical

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Carolle Laure Matene Fongang. "Refusal of care in vulnerable people: Case of the elderly." World Journal of Advanced Research and Reviews 18, no. 3 (2023): 859–73. http://dx.doi.org/10.30574/wjarr.2023.18.3.1136.

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Within the framework of the hospital, a medical act “can only be performed with the free and informed consent of the patient”. . . What are the levers for the healthcare professionals in order to have the care accepted? The problem that emerges from these first reflections is: “How can the healthcare professionals deal with a patient’s refusal of care?” The patient has the right to withdraw his consent, such as refusing an act, treatment or care. The refusal of care questions professionals even about the very meaning of their mission. It challenges them on the Health professionals-patient rela

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Ryoo, Joan J., Diana L. Ordin, Anna Liza M. Antonio, et al. "Patient Preference and Contraindications in Measuring Quality of Care: What Do Administrative Data Miss?" Journal of Clinical Oncology 31, no. 21 (2013): 2716–23. http://dx.doi.org/10.1200/jco.2012.45.7473.

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Purpose Prior studies report that half of patients with lung cancer do not receive guideline-concordant care. With data from a national Veterans Health Administration (VHA) study on quality of care, we sought to determine what proportion of patients refused or had a contraindication to recommended lung cancer therapy. Patients and Methods Through medical record abstraction, we evaluated adherence to six quality indicators addressing lung cancer–directed therapy for patients diagnosed within the VHA during 2007 and calculated the proportion of patients receiving, refusing, or having contraindic

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Carolle, Laure Matene Fongang. "Refusal of care in vulnerable people: Case of the elderly." World Journal of Advanced Research and Reviews 18, no. 3 (2023): 859–73. https://doi.org/10.5281/zenodo.8434671.

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Within the framework of the hospital, a medical act “can only be performed with the free and informed consent of the patient”<sup>. . . </sup>What are the levers for the  healthcare professionals in order to have the care accepted? The problem that emerges from these first reflections is: “How can the healthcare professionals deal with a patient’s refusal of care?” The patient has the right to withdraw his consent, such as refusing an act, treatment or care. The refusal of care questions professionals even about the very meaning of their mission. It chal

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Campbell, Mobola, Vanessa Ramirez-Zohfeld, Anne Seltzer, and Lee A. Lindquist. "Training Hospitalists in Negotiations to Address Conflicts with Older Adults around Their Social Needs." Geriatrics 5, no. 3 (2020): 50. http://dx.doi.org/10.3390/geriatrics5030050.

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Hospitalists care for a growing population of older patients with unique social needs that can often be addressed by providing caregiver help in the home. The importance of addressing social needs is well-recognized, yet older patients sometimes refuse these services. This refusal of services may result in rehospitalization and increased morbidity for patients. We aimed to overcome this refusal of social support through an innovative workshop training hospitalists in negotiation and dispute resolution. Hospitalists at a tertiary care, urban academic medical center completed a one-hour interact

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Cone, David C., David T. Kim, and Steven J. Davidson. "Patient-Initiated Refusals of Prehospital Care: Ambulance Call Report Documentation, Patient Outcome, and On-line Medical Command." Prehospital and Disaster Medicine 10, no. 1 (1995): 3–9. http://dx.doi.org/10.1017/s1049023x0004156x.

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AbstractIntroduction:There is a growing interest in cases in which emergency medical services (EMS) providers evaluate a patient, but do not transport the patient to a hospital. A subset of these cases, the patient-initiated refusal (PIR) in which the patient refused care and transport, was studied and evaluated. The objectives of the study were to examine the adequacy of ambulance call report documentation in PIR, to examine the clinical outcome of these patients in one hospital-based, suburban EMS system, and to assess the potential impact of on-line medical command (OLMC) on cases of PIR.Me

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Charron, Jalal, Pénélope Troude, Elise de La Rochebrochard, Christophe Segouin, and Prescillia Piron. "Notification of STI test results by text messaging: Why do patients refuse? Cross-sectional study in a Parisian sexual health centre." International Journal of STD & AIDS 33, no. 3 (2021): 257–64. http://dx.doi.org/10.1177/09564624211048555.

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Text messaging has been used to notify patients of results after sexually transmitted infection (STI) testing. This study aimed to characterise the population who refused notification of results by short message services (SMS) and to explore their reasons for refusing. From January to August 2018, 1180 patients coming for STI testing in a Parisian sexual health centre were offered SMS notification of their results, completed a self-administered questionnaire and were included in the study. Factors associated with refusal of SMS notification were explored using logistic regression models. Reaso

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Horner, Jennifer, Maria Modayil, Laura Roche Chapman, and An Dinh. "Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice." American Journal of Speech-Language Pathology 25, no. 4 (2016): 453–69. http://dx.doi.org/10.1044/2016_ajslp-15-0041.

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PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal featu

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Keen, Alyson, Kelli Thoele, Lisa Fite, and Shelley Lancaster. "Competent Patient Refusal of Nursing Care." Journal of Wound, Ostomy and Continence Nursing 46, no. 5 (2019): 390–95. http://dx.doi.org/10.1097/won.0000000000000569.

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Parker, Frederick R., and Charles J. Paine. "Informed Consent and the Refusal of Medical Treatment in the Correctional Setting." Journal of Law, Medicine & Ethics 27, no. 3 (1999): 240–51. http://dx.doi.org/10.1111/j.1748-720x.1999.tb01458.x.

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It was not until the nineteenth century that Western nations came to replace mutilation, corporal punishment, and banishment as the favored method of criminal punishment with the more humane concept of imprisonment. Even then, however, a convicted inmate was viewed as nothing more than a slave of the state, entitled only to the most basic of human rights and subject to the whim and peril of his jailor's desire. The shift to imprisonment gradually was accompanied by the additional humanitarian demand that prisons avail their charges of some minimum standard of human decency and necessity, which

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Syed Soffian, Sharifah Saffinas, Nazarudin Safian, Azmawati Mohammed Nawi, Shahrul Bariyah Ahmad, Huan-Keat Chan, and Muhammad Radzi Abu Hassan. "Rate and associated factors of refusal to perform immunochemical Faecal Occult Blood Test (iFOBT) among semi-urban communities." PLOS ONE 16, no. 10 (2021): e0258129. http://dx.doi.org/10.1371/journal.pone.0258129.

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The uptake of the immunochemical faecal occult blood test (iFOBT) in many countries with an opportunistic colorectal cancer (CRC) screening programme remains suboptimal. This study aimed to determine the rate, associated factors and reasons of refusal to perform the iFOBT test offered under an opportunistic CRC screening programme in semi-urban communities. This cross-sectional study was conducted among the average-risk individuals living in semi-urban areas, who sought care from public primary care centres across Kedah state, Malaysia. The information regarding the sociodemographic and clinic

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Doan, Long, and Matthew K. Grace. "Factors Affecting Public Opinion on the Denial of Healthcare to Transgender Persons." American Sociological Review 87, no. 2 (2022): 275–302. http://dx.doi.org/10.1177/00031224221082233.

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Between one-fifth and a third of people who are transgender have been refused treatment by a medical provider due to their gender identity. Yet, we know little about the factors that shape public opinion on this issue. We present results from a nationally representative survey experiment ( N = 4,876) that examines how common justifications issued by providers for the denial of healthcare, and the race and gender identity of the person being denied care, intersect to shape public opinion concerning the acceptability of treatment refusal. We find that religious objections are viewed as less acce

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Libraro, Kaitlyn, Jamie Heffernan, Jeremiah Lorico, Rachelle J. Lodescar, and Angela Rabbitts. "786 Guardian Refusal for Pediatric Burn Surgery, What Providers Need to Understand." Journal of Burn Care & Research 41, Supplement_1 (2020): S227—S228. http://dx.doi.org/10.1093/jbcr/iraa024.363.

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Abstract Introduction Pediatric patients, between the age of newborn and 18 years, require legal guardian consent for any surgical procedure. In some cases, despite medical advisement, guardians refuse excision and skin graft for a minor in their care. In these cases, extended healing times, re-admission, scaring, contracture and physical disability may ensue. Our study aims to review contributing factors of guardian refusal and explore the outcomes of such refusals. Methods Retrospective chart review of all pediatric patients admitted to a large verified burn center between January 2018 throu

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Shaw, David, Penney Lewis, Nichon Jansen, et al. "Family overrule of registered refusal to donate organs." Journal of the Intensive Care Society 21, no. 2 (2019): 179–82. http://dx.doi.org/10.1177/1751143719846416.

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It is well known that families frequently overrule the wishes of dying patients who had previously expressed a wish to donate their organs. Various strategies have been suggested to reduce the frequency of these ‘family overrules’. However, the possibility of families overruling a patient’s registered decision not to donate has not been discussed in the medical literature, although it is legally possible in some countries. In this article, we provide an ethical analysis of family overrule of a relative’s refusal to donate, using the different jurisdictions of the UK, Switzerland, Germany and t

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Baergen, Ralph Neil, and James Skidmore. "Conscience at the End of Life." Nursing Reports 14, no. 4 (2024): 4091–108. https://doi.org/10.3390/nursrep14040298.

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Background/Objectives: Caring for patients at the end of life can involve issues that are ethically and legally fraught: withholding or withdrawing artificial nutrition and hydration, pain control that could hasten death, aggressive treatment that is continued when it seems only to be prolonging suffering, patients who request medical assistance in dying, and so forth. Clinicians may find that their deeply held ethical principles conflict with law, institutional policy, or patients’ choices. In these situations, they may consider either refusing to participate in procedures that they find mora

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Lira, Gerlene Grudka, Cleide Maria Pontes, Janine Schirmer, and Luciane Soares de Lima. "Family considerations about the decision to refuse organ donation." Acta Paulista de Enfermagem 25, spe2 (2012): 140–45. http://dx.doi.org/10.1590/s0103-21002012000900022.

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OBJECTIVE: To understand the social representations that guided family decision to refuse organ donation for transplant and to identify the actions of the social environment that influenced this refusal. METHODS: Qualitative study using a descriptive exploratory design. Nine family members were interviewed between February and August 2009, whose family member death had been reported regularly by the Transplantation Center of Pernambuco. The statements underwent content analysis in semantic categories. RESULTS: Three semantic categories emerged which supported this study: The care and managemen

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U., Vidya B., and Anil Shetty K. "Study on demographic factors of discharge against medical advice in pediatric population." International Journal of Contemporary Pediatrics 7, no. 2 (2020): 359. http://dx.doi.org/10.18203/2349-3291.ijcp20200109.

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Background: Discharge against medical advice (DAMA) is of serious concern among the pediatrics population. Parent(s)/guardians understanding about the disease and various other factors play role in their decision of DAMA. The aim of this study is to know the prevalence of DAMA in a tertiary care center and to observe the gender stratification in DAMA.Methods: A retrospective survey of medical records of children discharge against medical advice during the period January 2017 to January 2019. Demographic data, length of hospital stay, clinical diagnosis and procedure refused was collected.Resul

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Macauley, Robert. "Parental Refusal of Palliative Care: Is It Medical Neglect? (416-B)." Journal of Pain and Symptom Management 41, no. 1 (2011): 237. http://dx.doi.org/10.1016/j.jpainsymman.2010.10.121.

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Sergienko, S. K., and O. N. Reznik. "Patient advance care planning in end of life care: international data review." Messenger of ANESTHESIOLOGY AND RESUSCITATION 21, no. 1 (2024): 75–87. http://dx.doi.org/10.24884/2078-5658-2024-21-1-75-87.

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Intensive care allows maintaining the vital functions of patients with irreversible brain damage for a long time. Under appropriate criteria, human death is determined by brain death, but most patients die after an undetermined period from the inevitable complications. Our legislation does not allow stopping futile treatment and letting a hopeless patient die naturally. In Russia, patient’s right to autonomy and self-determination is fulfilled through the informed consent or refusal to medical intervention. An adult comatose patient with a brain damage isn’t able to make this decision and sign

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Hotelling, Barbara A. "Teaching in a Patient-Centered Medical Home." Journal of Perinatal Education 20, no. 3 (2011): 163–65. http://dx.doi.org/10.1891/1058-1243.20.3.163.

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Teaching Lamaze International classes in a patient-centered medical home allows the childbirth educator the best environment for giving evidence-based information and empowering parents to give birth their way. Patient-centered medical home facilities and providers practice evidence-based care and adhere to the principles of family-centered maternity care. In patient-centered medical homes, women can expect to give birth using the Lamaze Healthy Birth Practices and to fully participate in their care with appropriate interventions and the right to informed consent and informed refusal.

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Erbay, Hasan, Sultan Alan, and Selim Kadioglu. "Attitudes of prehospital emergency care professionals toward refusal of treatment." Nursing Ethics 21, no. 5 (2013): 530–39. http://dx.doi.org/10.1177/0969733013505311.

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Introduction: Prehospital emergency medicine is a specific field of emergency medicine. The basic approach of prehospital emergency medicine is to provide patients with medical intervention at the scene of the incident. This special environment causes health professionals to encounter various problems. One of the most important problems in this field is ethics, in particular questions involving refusal of treatment and the processes associated with it. Objective: The objective of this study is to identify emergency health professionals’ views regarding refusal of treatment. Methods: This study

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Kröger, Edeltraut, Jocelyne Moisan, and Jean-Pierre Grégoire. "Billing for Cognitive Services: Understanding Québec Pharmacists' Behavior." Annals of Pharmacotherapy 34, no. 3 (2000): 309–16. http://dx.doi.org/10.1345/aph.19133.

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BACKGROUND: There is growing evidence that pharmacists' interventions to solve drug-related problems are effective and cost-saving. Since 1978, under the Québec provincial drug plan, payment for two cognitive services, the pharmaceutical opinion and the refusal to dispense a prescription, has been disbursed to community pharmacists. However, the number of claims for these services lags far behind expectations. OBJECTIVE: To identify factors influencing Québec community pharmacists in the billing for a pharmaceutical opinion or for a refusal to dispense. METHODS: Questions on predisposing, enab

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Jaury Douglas Pardomuan, Abdul Kolib, and Handoyo Prasetyo. "Legal Protection for Doctors Against Refusal of Medical Ser-vices by Elderly Patients in Indonesia." International Journal of Public Health 2, no. 2 (2025): 53–66. https://doi.org/10.62951/ijph.v2i2.430.

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The growing elderly population in Indonesia has created structural challenges in the health care system. One of the crucial challenges arises in the aspect of medical decision-making that becomes increasingly complex, along with the decline in cognitive capacity, comorbidities, and chronic diseases that accompany this age group. Problems arise when elderly patients refuse medical treatment, while doctors have ethical and professional obligations to save lives. This condition is complicated by social pressure from families and collective cultural values that often ignore the right to individual

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Cassell, Eric J. "Autonomy in the Intensive Care Unit: The Refusal of Treatment." Primary Care: Clinics in Office Practice 13, no. 2 (1986): 395–408. http://dx.doi.org/10.1016/s0095-4543(21)00988-x.

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Sochocka, Lucyna, Anna Widera, and Katarzyna Szwamel. "Intensity of the phenomenon of refusal to subject children to preventive vaccinations in the years 2002-2016 based on analysis of primary health care medical records." Medical Science Pulse 12, no. 3 (2018): 27–31. http://dx.doi.org/10.5604/01.3001.0012.5064.

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Background. Vaccinations are the most effective method for preventing infectious diseases. Massive implementation of long-term vaccinations strategies has resulted in elimination or a reduced incidence of many infectious diseases. Aim of the study. To evaluate the intensity of the phenomenon of refusal to subject children to preventive vaccinations by attempting to characterize the parental group who refuse to vaccinate their children, determining the type and number of unrealized vaccinations, and identifying the reasons for being unvaccinated. Material and methods. The research material was

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Романовский, Георгий Борисович. "О праве пациента на замену врача: законодательство и судебная практика". Demidov Law Journal 14, № 4 (2024): 336–47. https://doi.org/10.18255/2949-3439-2024-4-336-347.

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The article examines the legislative content of the patient’s right to replace the attending physician, as well as materials from judicial practice that make it possible to identify the most complex legal situations. A paired category is considered - the doctor’s ability to refuse to monitor the patient and treat him. Based on the materials of judicial practice, it is shown that the powers are not absolute. The main importance belongs to the principle of public health - the inadmissibility of refusal to provide medical care.

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Романовский, Георгий Борисович. "О праве пациента на замену врача: законодательство и судебная практика". Demidov Law Journal 14, № 4 (2024): 336–47. https://doi.org/10.18255/2306-5648-2024-4-336-347.

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The article examines the legislative content of the patient’s right to replace the attending physician, as well as materials from judicial practice that make it possible to identify the most complex legal situations. A paired category is considered - the doctor’s ability to refuse to monitor the patient and treat him. Based on the materials of judicial practice, it is shown that the powers are not absolute. The main importance belongs to the principle of public health - the inadmissibility of refusal to provide medical care.

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Samreen, Sana, Mahnaz Hakeem, Hafsa Zaheer, Ambreen Raza, and Abdul Gaffar Billoo. "Factors Associated with Parental Refusal for Lumber Puncture Among Children and Adolescent: A Cross Sectional Survey at a Tertiary Care Hospital." Pakistan Journal of Medical & Health Sciences 16, no. 10 (2022): 442–44. http://dx.doi.org/10.53350/pjmhs221610442.

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Introduction: The lumbar puncture is frequently used in medical facilities to collect data on the cerebrospinal fluid (CSF). The method aids in the diagnosis of conditions affecting the spine and brain's central nervous system. However, in routine practice out of the many challenges posed by the parents due to lack of education, denial of consent for this procedure is a great challenge at clinical settings. Objectives: To determine the association of various factors with parental refusal for lumbar puncture among pediatric population (age from 1 moth to 18 years). Materials and Methods: A desc

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Velkanthan, Muniandy, Lili Husniati Yaacob, Ahmad Imran, and Ireny Mohd Nazri Norzarina. "Ethical challenges in paediatric care: Leveraging the Malaysian Child Act 2001 for life-saving decisions – A case report." Malaysian Family Physician 20 (March 2, 2025): 15. https://doi.org/10.51866/cr.800.

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Refusal of medical treatment in paediatric case presents significant ethical and legal challenges, particularly when parental decisions conflict with a child’s welfare. We report a case of life-threatening congenital diarrhoea in a neonate where the parents initially refused hospital admission despite extensive counselling. Given the severity of the child’s condition, legal intervention under the Malaysian Child Act 2001 was necessary to ensure prompt medical care. This case underscores the importance of healthcare providers being well-versed in ethical principles and legal frameworks to prote

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Montanari Vergallo, Gianluca, and Antonio G. Spagnolo. "Informed Consent and Advance Care Directives: Cornerstones and Outstanding Issues in the Newly Enacted Italian Legislation." Linacre Quarterly 86, no. 2-3 (2019): 188–97. http://dx.doi.org/10.1177/0024363919837863.

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This article’s authors delve into, and comment on, some of the key provisions within law no. 219, passed in 2017, which came into full effect in 2018. The legislation presents several innovative aspects: (a) communication time is equated to care; (b) patients may turn down lifesaving treatments, yet doctors must put in place all suitable support processes, from a psychological standpoint as well, in order to make sure that patients make informed decisions in full awareness; (c) refusal to treatment may be expressed prior to the onset of the disease making the patient incapable, as long as the

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Desponds, Charlotte, Cyril Ducros, Carine Rochat, et al. "Improving uptake of colorectal cancer screening by complex patients at an academic primary care practice: a feasibility study." BMJ Open Quality 13, no. 3 (2024): e002844. http://dx.doi.org/10.1136/bmjoq-2024-002844.

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BackgroundRegular screening reduces mortality from colorectal cancer (CRC). The Canton of Vaud, Switzerland, has a regional screening programme offering faecal immunochemical tests (FITs) or colonoscopy. Participation in the screening programme has been low, particularly among complex patients. Patient navigation has strong evidence for increasing the CRC screening rate.Design and objectiveThis feasibility study tested patient navigation performed by medical assistants for complex patients at an academic primary care practice.Baseline measurementsA review of 328 patients’ medical charts reveal

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Hipskind, John E., JM Gren, and DJ Barr. "Patients Who Refuse Transportation by Ambulance: A Case Series." Prehospital and Disaster Medicine 12, no. 4 (1997): 45–50. http://dx.doi.org/10.1017/s1049023x00037808.

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AbstractIntroduction:Patients refusing hospital transportation occurs in 5% to 25% of out-of-hospital calls. Little is known about these calls. This study was needed to determine the demographics, inherent risks, and timing of refused calls.Methods:This was a prospective review of all run sheets of patients who refused transportation were collected for a two month period. Demographic data and medical information was collected. Each run was placed into one of three categories of need for transport and further evaluation: 1) minimal; 2) moderate; and 3) definite. The Greater Elgin Area Mobile In

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Burstein, Jonathan L., Judd E. Hollander, Robert Delagi, Matthew Gold, Mark C. Henry, and Jeanne M. Alicandro. "Refusal of Out-of-hospital Medical Care: Effect of Medical-control Physician Assertiveness on Transport Rate." Academic Emergency Medicine 5, no. 1 (1998): 4–8. http://dx.doi.org/10.1111/j.1553-2712.1998.tb02566.x.

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Bouthillier, Marie-Eve, and Lucie Opatrny. "A qualitative study of physicians’ conscientious objections to medical aid in dying." Palliative Medicine 33, no. 9 (2019): 1212–20. http://dx.doi.org/10.1177/0269216319861921.

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Background: Under Quebec’s Act respecting end-of-life care, physicians may refuse to provide medical aid in dying because of personal convictions, also called conscientious objections. Before legalisation, the results of our survey showed that the majority of physicians were in favour of medical aid in dying (76%), but one-third (28%) were not prepared to perform it. After 18 months of legalisation, physicians were refusing far more frequently than the pre-Act survey had anticipated. Aim: To explore the conscientious objections stated by physicians so as to understand why some of them refuse t

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Jones-Nosacek, Cynthia. "Conscientious Objection, Not Refusal: The Power of a Word." Linacre Quarterly 88, no. 3 (2021): 242–46. http://dx.doi.org/10.1177/00243639211008271.

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Conscientious objection (CO) in medicine grew out of the need to protect healthcare providers who objected to performing abortions after the Roe v. Wade decision in the 1970s which has since over time expanded to include sterilization, contraception, in vitro fertilization, stem cell research, and end-of-life issues. Since 2006, there has been a growing amount of published literature arguing for the denial of CO. Over the last three years, there has also been an increase in calling this conscientious refusal. This article will argue that the term conscientious objection is more accurate than c

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Grossman, Zachi, Diego van Esso, Stefano del Torso та ін. "PRIMARY CARE PEDIATRICIANSʼ PERCEPTIONS OF VACCINE REFUSAL IN EUROPE". Pediatric Infectious Disease Journal 30, № 3 (2011): 255–56. http://dx.doi.org/10.1097/inf.0b013e3181faaaa3.

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Porozova, I. Yu. "Peculiarities of self-defense of a responsible nature in legal relations on transplantation." Analytical and Comparative Jurisprudence, no. 1 (March 20, 2024): 223–28. http://dx.doi.org/10.24144/2788-6018.2024.01.38.

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The purpose of this study is to determine the features of self-defense of a responsible nature in legal relations related to transplantation. The following conclusions were made: 1) in legal relations with transplantation, the patient is the recipient, and in autotransplantation, the donor is also; 2) the donor and the recipient have the right to apply and independently choose methods of self-defense; the transplant coordinator is obliged to use the methods of self-protection of the patient's civil rights and interests provided by law; 3) the donor and the recipient, and in the cases provided

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Malysheva, Anastasia A. "Implementation of Principles of Obligatory Medical Insurance Within the Framework of the Financial Support of Free Medical Assistance: Tendencies of the Judicial Practice." Business security 2 (May 23, 2024): 27–32. http://dx.doi.org/10.18572/2072-3644-2024-2-27-32.

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At present, free medical care in Russia is provided mainly at the expense of compulsory medical insurance. This system is implemented in accordance with the principles enshrined in legislation. The degree to which they are observed in the framework of free medical care makes it possible to determine the effectiveness of the realisation of the right of citizens to health care and medical assistance. The article considers cases of judicial practice in disputes involving medical organisations regarding the financial provision of their activities in the context of compliance with the principles of

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Shen, Angela K., Robert W. Grundmeier, and Jeremey J. Michel. "Trends in Vaccine Refusal and Acceptance Using Electronic Health Records from a Large Pediatric Hospital Network, 2013–2020: Strategies for Change." Vaccines 10, no. 10 (2022): 1688. http://dx.doi.org/10.3390/vaccines10101688.

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Understanding trends in vaccine refusal is critical to monitor as small declines in vaccination coverage can lead to outbreaks of vaccine-preventable diseases. Using electronic heath record (EHR) data from the Children’s Hospital of Philadelphia’s 31 outpatient primary care sites, we created a cohort of 403,448 children less than age 20 years who received at least one visit from 1 January 2013 through 31 December 2020. The sample represented 1,449,061 annualized patient and 181,131 annualized preventive vaccination visits per year. We characterized trends in vaccine refusal and acceptance usin

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Ogando Portilla, N., S. M. Bañon González, and M. G. García Jiménez. "Multidisciplinary approach in old aged dying patients." European Psychiatry 41, S1 (2017): S581—S582. http://dx.doi.org/10.1016/j.eurpsy.2017.01.875.

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IntroductionOver centuries, clinicians have had the responsibility to take care of dying patients. Lately, the withdrawal of life sustaining treatments have assumed a main role in these patients because of ethical aspects. Competent patients have the right to refuse medical care but not always these rights are respected or even explained to them, especially if they are old or they don’t have any close family. A multidisciplinary team should agree on how they think it is best to care for the patient and whether withdrawal of medical interventions is appropriate by using patient's wishes.Objecti

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Tippett, Vivienne C., Kerrianne Watt, Steven G. Raven, et al. "Anticipated Behaviors of Emergency Prehospital Medical Care Providers during an Influenza Pandemic." Prehospital and Disaster Medicine 25, no. 1 (2010): 20–25. http://dx.doi.org/10.1017/s1049023x00007603.

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AbstractIntroduction:Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services.Problem:This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behaviora

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