Refuse Hospital Treatment?
Discussion
A friend has been unwell for a while, requiring many hospital visits over the last few years including one fairly recently. They are at home under assisted care and have now apparently decided that they don't want to go back into hospital at all. I'm fully aware of the implications of this but to what level can they refuse treatment and/or can they be taken against their will?
They are in poor general health and almost all invasive treatment has already been ruled out by the consultant as it will likely cause more harm than good. I'm also aware that there is a DNR in place.
They are in poor general health and almost all invasive treatment has already been ruled out by the consultant as it will likely cause more harm than good. I'm also aware that there is a DNR in place.
They should be able to sort out a full on hospice-at-home care plan that lays out exactly what would and would not hapen in specific circumstances. If someone thinks that they're not able to weigh up the pros and cons to make the decision, then they can ask the Court of Protection to make the decision for them, but the rules are VERY strict on how and when this can happen.
BlackVanDyke said:
They should be able to sort out a full on hospice-at-home care plan that lays out exactly what would and would not hapen in specific circumstances. If someone thinks that they're not able to weigh up the pros and cons to make the decision, then they can ask the Court of Protection to make the decision for them, but the rules are VERY strict on how and when this can happen.
I suspect my friend is just shuffling the pieces in place for the end game and I know I'd rather them pass as peacefully as possible in their chosen surroundings. Helping them as much as you are able to is one of the kindest things that any human can do for another; the dignity of dying in a place and at a time of one's own choosing is such a fundemental right IMHO.
I well remember having to become very firm with certain family members during my Grandmother's final illness about what part of "I'm 92, I just want to die in my own bed in the home I've lived in for 58 years" they couldn't get.
I well remember having to become very firm with certain family members during my Grandmother's final illness about what part of "I'm 92, I just want to die in my own bed in the home I've lived in for 58 years" they couldn't get.
arfur sleep said:
BlackVanDyke said:
They should be able to sort out a full on hospice-at-home care plan that lays out exactly what would and would not hapen in specific circumstances. If someone thinks that they're not able to weigh up the pros and cons to make the decision, then they can ask the Court of Protection to make the decision for them, but the rules are VERY strict on how and when this can happen.
I suspect my friend is just shuffling the pieces in place for the end game and I know I'd rather them pass as peacefully as possible in their chosen surroundings. Regarding whether they can refuse treatment, it depends on their 'capacity'. If it got to that point where they wanted to refuse treatment but others were thinking of forcing it upon then, then someone would do a capacity assessment. This would involve whether they could understand the consequences of refusing treatment, hold it in their mind for long enough and then repeat it back. If they have capacity then they can, of course, do whatever they like. Upsetting to others but if that was you then you'd want to have the freedom to do what you wanted to do.
Being forgetful or even having dementia don't preclude you from having capacity to make a decision, it depends on the assessment of their cognition at the time as described above.
Being forgetful or even having dementia don't preclude you from having capacity to make a decision, it depends on the assessment of their cognition at the time as described above.
On reflection it sounds like they are very poorly, so it might be for the best that they don't go into hospital. They aren't nice places and you can end up more sick by going in. Sometimes best to have the dignity of being at home. There are always options for symptom control, pain relief etc by palliative nurses/Macmillan nurses and GP.
Have you looked into slash read about a patient's advocate?
There are new guidelines about capacity, which is the ability of a person to make a balanced decision for themselves, and obviously no-one can take that away from you. But if you lose it yourself or are losing it, then independent and legally robust help is available.
IMCA or Independent Mental Capacity Advocate.
Purely there to help, never to see anyone off to the Pearly Gates
There are new guidelines about capacity, which is the ability of a person to make a balanced decision for themselves, and obviously no-one can take that away from you. But if you lose it yourself or are losing it, then independent and legally robust help is available.
IMCA or Independent Mental Capacity Advocate.
Purely there to help, never to see anyone off to the Pearly Gates
Edited by The_Doc on Monday 3rd June 20:52
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