Do I have the right to refuse medical treatment?

In the UK, we are entitled to receive free healthcare and set-priced prescriptions through the National Health Service. This is a benefit not afforded to everyone in the world and so it is often envied by people from other countries. However, some people may choose not to receive the treatment that is prescribed to them. There are a number of reasons why a person may want to refuse medical treatment and it is important to understand whether this is legal or not.

The following guide explains why a person might choose to decline treatment, whether doctors have to accept that decision, what must be done in order for that decision to be official and the times at which this choice could be overruled.

Why would someone refuse medical treatment?

There are several reasons why a person might choose to decline or stop treatment for a medical condition. Although this seems like a drastic choice, there can be several reasons that are understandable once considered, including:

• The patient doesn’t believe that the treatment is working or has seen no beneficial results of the treatment.
• The patient has suffered worsening symptoms or adverse effects from the treatment that was prescribed to them.
• The patient doesn’t agree with the diagnosis or prescription that was given.
• The patient has chosen to use alternative treatments such as natural remedies or therapies.
• The patient has decided that their life is drawing to an end and they would prefer to cease life-prolonging treatments.
• The patient has read negative reviews about the treatment or medicines prescribed and does not trust their reliability.

Ultimately, we are afforded personal choice and this means that people have the right to determine whether treatment plans and medicines are right for them and there are any number of reasons that an individual might agree or disagree with a prescription.

How does a person officially refuse medical treatment?

It is important that any person who wants to refuse medical treatment makes their decision official. Just in the same way that we each need to give permission for a doctor to treat us or a surgeon to operate on us, we are also entitled to have a decision to decline treatment be respected.

Doctors, family and friends may believe that a decision to refuse treatment is one that will result in an earlier death, greater discomfort, worsening symptoms or more pain, but if you choose to decline medicines or any other form of treatment, this must be respected.

In order for you to make a valid and official decision to decline treatment, your choice must have been made voluntarily and you must be fully informed about the options you have and the consequences of your voice.

Voluntary Decision

For your decision to refuse treatment to be valid, your decision must have been made voluntarily and you cannot have been coerced into taking this choice. The decision to refuse treatment must have been made by you alone and you should have suffered no pressure by a doctor, your family or friends to take this course of action.

Appropriately Informed

The validity of your decision will only be confirmed if you have received thorough information about your treatment, the benefits of receiving the treatment and the consequences of refusing it. Doctors will only be satisfied that your decision is valid if they believe that you understand what the treatment involves and what will happen if you do not receive the treatment.

Can my decision to refuse treatment be overturned?

If a person makes the decision to cease treatment or refuse treatment, it is essential that the medical team assess the validity of their decision as per the above. If it is deemed that the patient lacks the mental capacity to make this choice, health professionals can intervene.

Mental capacity is the term used to refer to a person’s ability to understand information fully and to use that information to make balanced decisions and to then communicate these decisions with others. Adults are considered to have mental capacity to make decisions relating to the medical treatment that they receive unless evidence suggests otherwise. There are a number of reasons that a person might lack mental capacity, including:

A person lacks mental capacity if is deemed that there is an impairment in their mind or that they are disturbed in some way, and this means that the person is not able to necessarily make sound judgements on their own behalf. Examples of occasions when a person’s mind is impaired could include:

• Some mental health conditions such as bipolar disorder or schizophrenia.
• Intoxication due to alcohol or drug use.
• Dementia.
• Illness or disorders that cause loss of consciousness or awareness, tiredness or confusions.
• Medications that cause the above symptoms. The symptoms must pass before the person will be able to make a decision in sound mind.

Making an Advance Decision

It is possible to make an advance decision if you are at least 18 years old, this is also known as a living will. The advance decision allows a person to decline specific medical treatments for a time in the future, in case they reach a point where they are unable to make a decision for themselves. Effectively, this means that the right to refuse treatment can be made in advance.

It is possible to refuse to receive treatment that could potentially keep you alive, these treatments are known as life-sustaining. This means that a person could make the advanced decision to refuse treatments such as CPR (cardiopulmonary resuscitation), and ventilation, which would be used if you are struggling to breathe. It is usually wise to discuss your advance decision with a doctor or other medical professional prior to making it to ensure that you are fully aware of your options and the consequences of your decision.

It is essential that a person who is making an advanced decision list the specific treatments and medicines that they wish to refuse in order for them not to be administered.
An advance decision can only be made by a person over the age of 18 who has the mental capacity to make the decision, usually with the advice of a medical practitioner. In order for the advance decision to be official, it must be:

• Written down
• Signed by the person making the advance decision
• Signed by a witness.