HOME

AGAINST
ADVICE

BUGTONG | CASTRO | GINEZ | ANGLUBEN

BATINO | CHUCUEN | COMPELIO
DACAPIAS | LANGPUYAS | PASCUA
HOME AGAINST ADVICE

A patient chooses to LEAVE the hospital

BEFORE the treating physician
recommends discharge.
MAIN BIOETHICAL PRINCIPLES INVOKED:

AUTONOMY

NON
BENEFICENCE
MALEFICENCE
 WHO LEAVES AGAINST MEDICAL ADVICE?
History of
Alcohol or HIV/ Absence
home
substance of health
AIDS against
abuse insurance
advice

Low
Psychiatric
Male sex socioeconomic
disturbance
Homeless
status
 MANAGEMENT:
ESTABLISH COMMUNICATION

1. Can the patient communicate choices?

2. Can the patient understand relevant information?
3. Can the patient appreciate the situation and consequences?
4. Can the patient manipulate the information rationally?
 IMPLICATIONS OF HAMA

POTENTIALLY CURABLE PATIENT

TERMINALLY ILL OR DYING PATIENT

 POTENTIALLY CURABLE PATIENT

Complete
Established Still REFUSE INFORMED
treatment
COMPETENCY treatment REFUSAL
INFORMATION
 DYING OR TERMINALLY ILL PATIENT

Cure no longer Give SUPPORT HOME WITH GOOD

attainable and
MEDICAL ADVICE
“MEDICAL FUTILITY” INFORMATION
HOME WITH GOOD MEDICAL ADVICE

PREPARE & • What to expect

ADVISE: • What could be done

• Current condition
ISSUES TO BE
• Anticipated death
DISCUSSED:
• Probable symptoms
 SUMMARY
HOME AGAINST
ADVICE • Potentially curable patients

HOME WITH GOOD

MEDICAL ADVICE • Dying patients