If a patient wishes to leave against medical advice but has capacity, what is the appropriate action?

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Multiple Choice

If a patient wishes to leave against medical advice but has capacity, what is the appropriate action?

Autonomy with capacity guides what happens when a patient wants to leave against medical advice. If the patient is able to understand information, appreciate the consequences, reason about options, and communicate a clear choice, they have the right to make that decision about their own care—even if you disagree or believe staying is safer. The proper approach is to acknowledge the decision and not try to coerce the patient to stay. Have a calm, thorough discussion to ensure they understand the risks and possible outcomes of leaving, then document the voluntary discharge and the patient’s capacity. Provide clear discharge instructions, including safety guidelines, warning signs to monitor, any needed medications, and plans for follow-up or outpatient care when possible. This preserves the patient’s rights while also supporting their safety and continuity of care. Forcing discharge, ignoring the request, or letting a family member decide when the patient is capacitated would undermine the patient's autonomy and is inappropriate.

Autonomy with capacity guides what happens when a patient wants to leave against medical advice. If the patient is able to understand information, appreciate the consequences, reason about options, and communicate a clear choice, they have the right to make that decision about their own care—even if you disagree or believe staying is safer.

The proper approach is to acknowledge the decision and not try to coerce the patient to stay. Have a calm, thorough discussion to ensure they understand the risks and possible outcomes of leaving, then document the voluntary discharge and the patient’s capacity. Provide clear discharge instructions, including safety guidelines, warning signs to monitor, any needed medications, and plans for follow-up or outpatient care when possible. This preserves the patient’s rights while also supporting their safety and continuity of care.

Forcing discharge, ignoring the request, or letting a family member decide when the patient is capacitated would undermine the patient's autonomy and is inappropriate.

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