THE PATIENT'S RIGHT TO REFUSE
Section I: THE RIGHT TO REFUSE TREATMENT
THE RIGHT TO CONSENT IMPLIES THE RIGHT TO REFUSE
a. Adequate Mental Capacity. An adult patient who is conscious and has
adequate mental capacity has the right to refuse any medical or surgical procedure.
Similarly, most courts have found that surrogate decision makers acting on behalf of
incompetent adults and minors have the right to refuse, in appropriate situations. But,
those making decisions for others have a narrower range of choices, because of the
duty to act with the best interests of the patient in mind.
Protection of those with diminished
Respect for persons.
Right to self-determination.
Right to protection.
Right to consent and refuse.
Limited right to consent and refuse.
Figure 2-1. Those making decisions for children and incompetent adults have a more
limited right to refuse treatment.
b. Overriding State Interests. While the right to refuse treatment is recognized
in appropriate situations, the courts have found state interests to outweigh the patient's
right to autonomy in some cases. The state must, however, show a compelling
overriding interest to overrule a patient's refusal. The state's interest in promoting the
welfare of children, for example, could justify an order for compulsory care to save the
life of a pregnant woman or the mother of young children. When the patient's right to
refuse is honored, however, the patient may have to forego other benefits. (See other
column.) The legal bases for refusal of treatment include: 1) the common law right to
freedom from nonconsensual (unauthorized) invasion of bodily integrity; 2) the
constitutional rights of privacy and liberty; and 3) the constitutional right to freedom of