Navigating Care Refusal and Noncompliance in Patients with Opioid Use Disorder.
J Emerg Med
; 67(2): e233-e242, 2024 Aug.
Article
in En
| MEDLINE
| ID: mdl-38849254
ABSTRACT
BACKGROUND:
For many emergency physicians (EPs), deciding whether or not to allow a patient suffering the ill effects of opioid use to refuse care is the most frequent and fraught situation in which they encounter issues of decision-making capacity, informed refusal, and autonomy. Despite the frequency of this issue and the well-known impacts of opioid use disorder on decision-making, the medical ethics community has offered little targeted analysis or guidance regarding these situations.DISCUSSION:
As a result, EPs demonstrate significant variability in how they evaluate and respond to them, with highly divergent understandings and application of concepts such as decision-making capacity, informed consent, autonomy, legal repercussions, and strategies to resolve the clinical dilemma. In this paper, we seek to provide more clarity to this issue for the EPs.CONCLUSIONS:
Successfully navigating this issue requires that EPs understand the specific effects that opioid use disorder has on decision-making, and how that in turn bears on the ethical concepts of autonomy, capacity, and informed refusal. Understanding these concepts can lead to helpful strategies to resolve these commonly-encountered dilemmas.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Treatment Refusal
/
Decision Making
/
Opioid-Related Disorders
Limits:
Humans
Language:
En
Journal:
J Emerg Med
Journal subject:
MEDICINA DE EMERGENCIA
Year:
2024
Type:
Article