Every patient has the right to refuse treatment in the same way that every patient has the right to access healthcare; however there are times that we as healthcare professionals forget that the patients have the right to refuse treatment.
Sometimes it is really frustrating and annoying for a student to go to a patient and be all friendly and the patient refuses the treatment even after knowing all the benefits of and implications of not accepting treatment. We are sent out to various wards to treat patients with various conditions and when a patient refuses it feels as if the patient is taking away the opportunity to learn something new, as all conditions are the same by the book but they all present differently in real life situations. I have to be honest, when certain patients with certain medical conditions refuse treatment I sometimes feel relieved, but then when you report back to the clinicians they sometimes tell you to be sterner. I am not a very stern person and I feel bad for making people do things they do not want to do even though it will benefit them.
I had a patient who was really ill but not very weak. The doctors needed a sputum sample to investigate whether or not she had TB and she was referred to me for a sputum induction. As this was my first attempt at obtaining sputum I went to check on the patient got some background information and saw that the patient was already on TB medication, even though I was really confused and continuously questioned it I carried on with my assessment. This poor women, refused all my treatment sessions, bribery only worked once and she refused to take the TB medication that was given to her in liquid form. After a session with her throwing a tantrum like a little child I immediately went to the clinician and explained that I have tried on many occasions to get this woman to cooperate and she constantly refused, I was forced to make her comply to the treatment as the clinicians felt that mobilization would benefit her. At this point I no longer felt like I was learning anything and that the constant reasoning with the patient has now become tedious. She never said she wanted to die, she kept asking to go home, but the fact that she wasn’t taking any medication to me was a sign of death approaching and I was not very comfortable treating someone in that state.
After 3 days the patient was moved into an isolated room. Isolation rooms for some strange reason scared me to death. Every day I walked into the room my patient would start crying and always looked away. Her physical and mental state had deteriorated and she was no longer able to even go to the toilet, because of her state and because of the fact that I was forced to see this patient even though I was uncomfortable, I would go to her room everyday for 5 mins. Talk to her and pretend that I was treating her. I was seeing this poor woman for two weeks and at the end of the two weeks she had passed on.
Part of me wanted to approach my clinician and ask her if she had any remorse for trying to put a dying woman through more agony than what she had already been going through. Sometimes we think we know what’s best for our patients when all they want is to be left alone so that they can die in peace.
Hospital, U. P. (2014). Patient’s bill of rights. Retrieved 03 20, 2017, from UCT Private Academic Hospital: http://www.ucthospital.co.za/content/patient-bill-of-rights