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11 Am. J.L. & Med. 147 (1985)
The Patient Who Refuses Medical Treatment: A Dilemma for Hospitals and Physicians

handle is hein.journals/amlmed11 and id is 157 raw text is: The Patient Who Refuses Medical
Treatment: A Dilemma for Hospitals
and Physicians
Martha Swartz*
ABSTRACT
This Article reviews recent case and statutory law concerning patients
who refuse medical treatment. Among the special cases considered are:
1) the competent adult patient who refuses treatment on religious or
privacy grounds; 2) the incompetent patient whose own wishes were
never expressed, but whose family refuses treatment; 3) the incompetent
patient who expressed the wish not to be treated before becoming incom-
petent; and 4) parents who refuse treatment on behalf of their child.
It is pointed out that recent court decisions have blurred the distinc-
tions between extradordinary care and ordinary care and between
withholding and withdrawing life-sustaining treatment. Reference is
made to the recent trend toward allowing the family of an incompetent
patient to assert the patient's rights without court intervention either in
the form of direct court order or through guardianship proceedings.
Finally, the implications of these legal developments for health care
institutions are discussed. A protocol pertaining to incompetent patients
is proposed. Health care institutions are encouraged to develop formal
policies for dealing with patients who refuse treatment, and to work with
their professional associations in lobbying for legislation which will
clarify the law in this area.
I. INTRODUCTION
A 24 year old Jehovah's Witness is wheeled into the hospital emer-
gency room suffering from a life-threatening blood loss. Before she loses
consciousness, she specifically rejects the physician's recommendation that
she receive blood transfusions. In another part of the hospital, an 88 year
old man suffering from terminal cancer lies comatose, sustained on a
* Martha Swartz received her B.A. from the University of Michigan in 1971; M.S.S. from
Bryn Mar College in 1976 and her J.D. from the University of Pennsylvania School of Law in
1980.

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