Can doctors refuse treatment for patients? The answer is, ‘it’s complicated’. Depending on your country of residence and the circumstances in which the decision was taken, different attitudes may prevail.
In some cases, doctor can refuse patients if they are threatening violent behavior with the doctor and the staff. There could be extenuating circumstances such as a patient during a mental health crisis. In such cases security personnel might be required to assist in delivery of care.
Doctors should not provide treatment beyond their scope of expertise. For example if an ENT specialist encounters a patient with cardiological conditions, the doctor should decline treatment as they are not trained in that specific discipline and may not have the knowledge about the latest treatment guidelines in that field. In fact, administering therapy in such cases might cause more harm and put the patient under higher risk of complications.
A third way in which a doctor could refuse treatment is if the patient requests certain medications to be prescribed even if investigatory tests indicate otherwise. For example, if a patient with a viral infection in their ear comes and requests for an antibiotic, it is up to the doctor to a) not prescribe it as antibiotics are ineffective in treating viral infections and b) explain the rationale to the patient to ensure effective communication. Opioids are another example of drugs that should be prescribed only after careful consideration as they are prone to be abused by patients.
What do medical bodies say?
The British Medical Association condones the act of conscientious objection whereby a doctor is entitled to have their own personal beliefs and values just as any other member of the society. The doctor may object to providing clinically appropriate treatment if it conflicts with their personal beliefs. However, doctors can claim conscientious objection only if it is lawful, non-discriminatory, does not cause harm to their patients, or deny them access to medical services. It is only valid for special cases of abortion and fertility treatment in the UK.
Dilemma of the pandemic
The COVID-19 pandemic saw healthcare professionals being disproportionately affected by the virus and thus endangering their lives. The question of refusal of treatment at such a time was discussed in countries across the world. Hui-Siu Tan said in a blog (Journal of Medical Ethics, BMJ) that Malaysian doctors could not refuse treatment of COVID-19 patients as it would violate the principles of medical ethics and human rights, as well as harm public health efforts to control the spread of the virus. The writer added that private providers have a responsibility to prioritize public health and provide care to all patients, regardless of their COVID-19 status. However, it is also the duty of the government to provide guidance and support to private healthcare providers to ensure that they are able to provide safe and equitable care during the pandemic.
References
- Scavone F. Conscientious objection and expressing personal beliefs. The British Medical Association is the trade union and professional body for doctors in the UK., https://www.bma.org.uk/advice-and-support/ethics/personal-ethics/conscientious-objection-and-expressing-personal-beliefs (2021, accessed 28 March 2023).
- Can a Doctor Refuse to Treat a Patient? Law Office of David A. Kates, PLLC, https://www.davidkates.com/blog/2021/september/can-a-doctor-refuse-to-treat-a-patient-/ (accessed 28 March 2023).
- Skerrett P. Not so conscientious objection: When can doctors refuse to treat? STAT, https://www.statnews.com/2019/11/08/conscientious-objection-doctors-refuse-treatment/ (2019, accessed 28 March 2023).
- Tan H-ST. Can Malaysian Private Healthcare Providers Refuse to Treat Patients with COVID-19? Journal of Medical Ethics blog, https://blogs.bmj.com/medical-ethics/2021/01/20/can-malaysian-private-healthcare-providers-refuse-to-treat-patients-with-covid-19/ (2021, accessed 30 March 2023).
