Treatment Over the Objection of Incapacitated Patients in Acute-Care Hospitals: A Systematic Literature Review
Hamrick, Corinne
:
2022
Abstract
Patients determined to be incapacitated by physicians, due to psychiatric disorder, chemical dependence, trauma, dementia, or other illnesses, are vulnerable to forced care by medical professionals. Instances of forced care can be ethically distressing to both patient and clinician, as each party experiences the tensions between the principles of autonomy, beneficence, and nonmaleficence. Deciding not to treat over the objection of an incapacitated patient can be justified for several reasons, all of which assumes the risk of allowing a condition to remain untreated. However, in deciding to treat over the objection of a patient, one traverses the boundary of individual autonomy, deeming the treatment both necessary and in the patient’s best interest. Although significant research has been conducted on these issues in the context of a psychiatric hospitalization, little is known about the practices of treating over-objection in general acute-care hospitals. Ultimately, in order to maintain an ethical standard with which to evaluate and treat incapacitated patients, clinicians should determine a patient’s reason for refusal, their best interest in a given circumstance, and assess various treatments for their various benefits and burdens imposed by implementation.