LEGAL PRINCIPLE: MEDICAL LAW – Duty of Medical Practitioner – Patient’s Refusal of Consent – Effect
PRINCIPLE STATEMENT
Since the patient's relationship with the practitioner is based on consensus, it follows that the choice of an adult patient with a sound mind to refuse informed consent to medical treatment, barring state intervention through judicial process, leaves the practitioner helpless to impose a treatment on the patient. That helplessness presents him with choices. He could terminate the contract, and, I would say, callously, force the patient out of his clinic or hospital; he could continue to give him refuge in his hospital and withdraw any form of treatment; he could do the best he could to postpone or ameliorate the consequences of the patient's choice. To a large extent the practitioner should be the judge of the choice that may be better in the circumstances. The choices become a question of personal attitude rather than one of professional ethics.
RATIO DECIDENDI (SOURCE)
"Since the patient's relationship with the practitioner is based on consensus, it follows that the choice of an adult patient with a sound mind to refuse informed consent to medical treatment, barring state intervention through judicial process, leaves the practitioner helpless to impose a treatment on the patient. That helplessness presents him with choices. He could terminate the contract, and, I would say, callously, force the patient out of his clinic or hospital; he could continue to give him refuge in his hospital and withdraw any form of treatment; he could do the best he could to postpone or ameliorate the consequences of the patient's choice. To a large extent the practitioner should be the judge of the choice that may be better in the circumstances. The choices become a question of personal attitude rather than one of professional ethics."
EXPLANATION / SCOPE
An adult patient with a sound mind has the right to refuse informed consent to medical treatment. Without state intervention (e.g., court order), the practitioner cannot impose treatment. The practitioner has choices: terminate the relationship, withdraw treatment, or ameliorate consequences. The choice becomes a matter of personal attitude, not professional ethics. The principle respects patient autonomy and bodily integrity. The practitioner cannot be disciplined for respecting a competent patient’s refusal. The patient’s decision binds the practitioner. The practitioner’s duty does not override patient consent. The principle applies to all medical treatment, including life-saving measures. The state may intervene only through judicial process with compelling justification. The practitioner’s ethical duty yields to patient autonomy.