Discharge against medical advice

It is established in law that patients are entitled to consent or refuse medical treatment. They can therefore leave hospitals “against medical advice” (AMA). This is a growing phenomenon worldwide that may result in adverse medical outcomes and malpractice litigation. “Discharge AMA” (DAMA) is a conflict between patients’ rights and doctors’ duty of care. Health care providers usually refer patients to a DAMA form, but this does not completely waive doctors’ liability. Even if patients are partly responsible for bad health outcomes, health care providers may nevertheless be liable for negligence. Medical providers’ decision-making should follow a protocol based on strong communication skills and appropriate documentation to protect against liability. This article analyses DAMA in Australia by reviewing reasons for the phenomenon, the population affected, its legal consequences, and recommendations to prevent lawsuits in negligence. Lastly, the dichotomy between doctors’ duties of care and patients’ rights to refuse is analysed.