Decision Algorithm for Right to Refuse Treatment *
Does Patient have Decision Making Capacity
1. Does the patient comprehend the information presented to him/her? Yes
2. Does the patient understand the consequences of the options presented?
No
3. Is the patient able to make and communicate a decision?
Unsure
Patient Makes Treatment Decisions
Yes
Patient Does have Valid Durable Power of Attorney for Healthcare which Mirrors Current Clinical Situation (See Checklist)
Consult Psych
Does Patient Have Decision Making Capacity
Yes
1) Psych to confirm capacity 2) Second physician corroborate diagnosis, prognosis & appropriateness of medical treatment decision
No
Guardian?
Patient Advocate Makes Decision in accordance with Patient’s Wishes * This decision-making algorithm presumes that the patient's decision is not contradictory to the institution's ethical policies or to the law; where serious conflict of this nature is present, appropriate consultation is warranted.
Consult:
No
Family? Yes Yes Surrogate Decision Maker (SDM - See Algorithm for SDM)
Contact Social Work and/or Legal Counsel and/or Ethics Committee