Discharge against medical advice - some causes and consequences

Kevin Moissinac¹, Se To Boon Chong², Sukumar Mahesan² and Ahmad Tajudin Jaafar³

1. Penang Medical College

2. Hospital Pu/au Pinang

3. Ministry of Health, Malaysia.

Correspondence: Dr K Moissinac; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

CITATION: Kevin Moissinac, Se To Boon Chong, Sukumar Mahesan, Ahmad Tajudin Jaafar. Discharge against medical advice-some causes and consequences. International Medical Research Journal. 2002;6(1):11–4. 

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ABSTRACT

Patients who self-discharge against medical advice can pose clinical, moral, ethical and medico-legal problems. Reasons for self-discharge against medical advice include personal and/or financial obligations, refusal of inpatient treatment, desire to seek inpatient treatment at a different or private hospital, and to seek an alternative form of therapy. In general, self-discharge against medical advice has been associated with patient socio-economic and domestic disadvantage. The potential adverse complications of self-discharge include clinical deterioration and subsequent need for more intensive and expensive therapy, injury and property damage suffered by a third party and legal action by the patient or a third party for alleged malpractice. Allowing self-discharge against medical advice may expose clinicians to subsequent legal proceedings. Measures which may be taken to decrease potential problems include thorough, good clinical practice with impeccable documentation of inpatient treatment progress and procedures, and ensuring that patients, their relatives or representatives understand the possible consequences of self-discharge against medical advice.

KEYWORDS: self-discharge, against medical advice