Refusal of treatment

Hi everyone!

Recently I’ve been thinking about a situation at my work, that put me in a personal dilemma. Well maybe not dilemma, depends on your definition of dilemma.

As you might have read in my introduction I’m a physiotherapist. For a few years I worked in a rehabilitations center for paralyzed people.

So to make a long story short, there was a newly tetraplegic patient. I got the order from the responsble doctor to mobilise him into the wheelchair. After a patient is stable, in Switzerland it’s the normal procedure to get patients aut of bed as soon as possile.

So I went to the patient wanting to get him up. He refused because he felt a lot of pain when someone moved him around. I tried for a few days but he kept refusing to get up even after I explained to him why it is important for him to get up etc.

So what now??????

Do you mobilise a patient against his wish? Do you respect his will until he’s ready to get up?

My personal believe is to respect everyones autonomy and respect peoples wishes. Especially when people are not able to defend themselves physically.

In contrary as a physical therapist I have different responsibilities for different parties. I should provied the best therapy I can to the patient, I should follow the doctors order, I should advance the rehabilitation as fast as possible so the costs won’ get too high for the insurance etc.

Should I wait for the patient to be ready? Take him up against his will? Is it my responisbility to make this decision? Do I have to follow a doctors order even if it is against my personal believes?






One Reply to “Refusal of treatment”

  1. Hi!

    I have experienced this exact same thing multiple times where the patient’s refused to be mobilized. I would try and try to convince the patient to mobilize by explaining the benefits thereof. However, after multiple attempts the patient refused and I went and spoke to my clinician about it. They had said that I should try one last time and if the patient refuses again, I should speak to the Dr in charge. I did so and the Dr said that I should persist. Dr’s, however, do not realize that there is only so much convincing that we can do and that there are more patients that we are responsible for. Furthermore, we have learned that patients have a right to refuse treatment and it is unethical and unprofessional to force a patient to do something that they do not want to do.

    I personally feel that if you have done as much as you possibly could, then you have done your job and served your responsibility to the patient as a Physiotherapist.
    Kindest regards,


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