refusal

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refusal

The depth below which a pile cannot be driven.
References in periodicals archive ?
Having patients' signed informed consent or informed refusal documents (when appropriate) helps protect the office.
The law of informed consent defines the right to informed refusal. Thus, each case must establish:
The American Nurses Association has called annual influenza immunization of nurses "an ethical responsibility." Their web site states the ANA is "adamant about nurses receiving flu vaccine ..." Several other professional organizations (the Society of Hospital Epidemiologists of America and the Infectious Diseases Society of America) as well as the Centers for Disease Control and Prevention not only recommend yearly influenza vaccinations for all HCWs with direct patient contact but also recommend obtaining a signed declination (informed refusal form) from HCWs who decline influenza vaccination for reasons other than medical contraindications.
At law, there would always need to be provision for an "informed refusal".
To ensure that the patient's right to an informed refusal of transport has not been violated, the documentation does not necessarily reflect that the patient understood the discussion.
However, the doctor's decision may be based on the patient's wishes in an advance directive such as a living will or informed refusal by the patient or his or her representative.
Nonetheless, I think it is important to protect a pregnant woman's right to informed refusal even when, as a physician, I don't necessarily agree or feel comfortable with the decision.
At this point, inform the patient of the possible consequences of no treatment and secure an informed refusal, either by signed form or documentation in the patient's record.
I surmise in-office clinical computer access for both physicians and patients will be driven by the demand for more sophisticated patient education (informed consent informed refusal), multimedia programs that can calculate individuals' likely benefits and risks, allowing patients to spend hours (if needed) making choices about management options for their conditions (eg, breast cancer, benign prostatic hyperplasia) based on their individual circumstances.
In addition, it is an ethical imperative that the health care practitioner recognises and respects the patient's choice of decision, which may be that of informed refusal rather than consent.