Right to refuse treatment.
- Author:
Rodel V CAPULE
- Publication Type:Others
- Keywords:
Patient's RightsPatients' RightsRight To TreatmentMedical TreatmentMinorPatient ElopementPatient Refusal Of TreatmentRefusal Of Treatment
- MeSH:
Human;
Male;
Female;
Aged 80 And Over;
Aged;
Middle Aged;
Adult;
Young Adult;
Adolescent;
Child;
Child Preschool;
Infant;
Infant Newborn;
Patient Rights;
Human Rights;
Minors;
Treatment Refusal
- From:
Philippine Journal of Internal Medicine
2012;50(3):V-V
- CountryPhilippines
-
Abstract:
"Every human being of adult years and sound mind has a right to determine what shall be done with his own body...." It is a "basic and constitutionally predicated right" and courts have consistently "upheld a patient's right to refuse medical treatment even at risk to his health or his very life." It is recognized as a part of the right of privacy protected by both thestate and [federal] constitutions. Its exercise requires no one's approval. It is not merely one vote subject to being overridden by medical opinion. It follows that [such] a patient has the right to refuse anymedical treatment, even that which may save or prolong her [his] life. In other words, "the patient himself should then be the ultimate decision maker" and accordingly, "[a] physician shall respect the right of the patient to refuse medical treatment. Even substitute decision maker (parents, spouse, guardian, health care proxy) "ought to be guided in his or her decisions first by his knowledge of the patient's own desires and feelings..."What if the patient is a minor? Under Republic Act 68098 "[E]mancipation takes place by the attainment of majority. Unless otherwise provided,majority commences at the age of eighteen years." Understandably, a person less than 18 years old is a minor and conversely, any person at least 18 years old is considered a "human being of adult years and sound mind." The law made it clear that a minor could not enter into a contract with a physician for medical and surgical treatment. In the same manner, an attending physician cannot validly honor a refusal for treatment by a minor. According to the court, "most children, even in adolescence, simply are not able to make sound judgments concerning many decisions, including their need for medical care or treatment. Parents can and must make those judgments." A physician therefore must obtain theconsent of the child's parent or someone standing in loco parentis to the minor. Take note that the concept of "emancipated minor" or "mature minor" no longer exist under the law. "The only acceptable exception was an emergency, when it was either impractical to obtain parental consent, or any delay would unduly endanger the patient's life."On one hand, the definition of "sound mind" "in the context of refusing medical treatment means that the patient can understand the risks and benefits of the proposed treatment, and the patient is able to make an informed choice."However, caution must be made in labelling a psychiatric patient as "mentally incompetent" because "[i]n some situations, psychiatric patients are "mentally competent" for purposes of refusing medical treatment.Like any other rights under the constitution and laws, the right of a parent or guardian to refuse medical treatment of a minor or mentally incompetent is not absolute. "Traditionally, the law has recognized the fundamental right of parents to make decisions regarding the care of their children. This right is based on the premise that children generally lack the maturity and experience necessary to make reasonable, informed decisions regarding their own care and that parents presumably act in the best interests of their children." Under the principle ofparens patriae, "which translates to "parent of the country," the state may, and in some cases must, act as guardian of those who are under a legal disability to act on their own behalf, including children. This intervention may involve the appointment of a guardian for the child and/or prosecuting parents for neglecting their child's health." Simply put, the state can intervene and remove that right if the parent or guardian is not acting in the best interest of the minor.Respect for [adult] patient's autonomy mandates physicians and hospitals to honor a patient's informed refusal of any kind of treatment. Furthermore, a physician must competently determine if the parents or surrogate decision maker is acting in the best interest of a minor. In a way, a physician is also a surrogate decision maker for a minor.
