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Court Involvement

The refusal of care by an adult with a treatable condition is a legally complex situation, despite the well-settled rule that there is no liability for following the patient's wishes. A competent adult has the right to refuse any and all medical care. This right includes the refusal of livesaving emergency care. Such care could be legally rendered without the patient's consent, but not in the face of the patient's refusal to consent. the health care providers have no legal duty or legal right to save patients from themselves. If the patient is competent and refuses lifesaving care, the health care providers cannot be held liable for the consequences of the patient's refusal of care. The only duty the health care providers owe is the duty to warn the patient of the consequences of refusing care.

Usually, the reason competent adults refuse lifesaving medical treatment is based on religious beliefs. Any adult that chooses to refuse some or all care should sign a refusal-of-care form. Some groups, such as Christian Scientists, refuse all care. Others refuse certain types of care, such as blood transfusions or abortions. If the health care providers or patient's family wish to fight the patient's refusal of care, the proper forum is a guardianship hearing. The court is petitioned to appoint a guardian to consent to medical care for the patient.

To appoint this guardian, the court must interfere with two strongly protected freedoms, the freedom to control one's own body, and the freedom of religion. Courts are reluctant to disregard these freedoms and will appoint a guardian only upon a very persuasive showing. The court may not question the "reasonableness" of the religious belief, but it may question the tenacity with which it is held. For example, in one case, a court appointed a guardian for a patient who refused a blood transfusion, asserting that, while she would be damned for personally consenting to the transfusion, she would not be damned if it was given to her without her permission.

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