Laws on the right to refuse care and treatment

Key:

USC – United States Code

CFR – Code of Federal Regulations

H&S – Code California Health and Safety Code

Laws on the right to refuse care and treatment:

  • 22 CCR §§72527(a)(4) & 72528(b)(6)
  • H&S Code §1599.72
  • 42 CFR §483.10(b)
  • Note: The excerpt of the following regulation contains pertinent provisions on the right to refuse treatment but excludes other parts of the regulation.

    California Code of Regulations, Title 22, Section 72527(a)(4)

    Patients’ Rights.

    (a) Patients have the rights enumerated in this section and the facility shall ensure that these rights are not violated. The facility shall establish and implement written policies and procedures which include these rights and shall make a copy of these policies available to the patient and to any representative of the patient. The policies shall be accessible to the public upon request.

    Patients shall have the right:

    (4) To consent to or to refuse any treatment or procedure or participation in experimental research.

    Note: The excerpt of the following regulation contains pertinent provisions on the right to refuse treatment but excludes other parts of the regulation.

    California Code of Regulations, Title 22, Section 72528(b)(6)

    (a) It is the responsibility of the attending licensed healthcare practitioner acting within the scope of his or her professional licensure to determine what information a reasonable person in the patient’s condition and circumstances would consider material to a decision to accept or refuse a proposed treatment or procedure. Information that is commonly appreciated need not be disclosed. The disclosure of the material information and obtaining informed consent shall be the responsibility of the licensed healthcare practitioner who, acting within the scope of his or her professional licensure, performs or orders the procedure or treatment for which informed consent is required.

    (b) The information material to a decision concerning the administration of a psychotherapeutic drug or physical restraint, or the prolonged use of a device that may lead to the inability of the patient to regain use of a normal bodily function shall include at least the following:

    (1) The reason for the treatment and the nature and seriousness of the patient’s illness.

    (2) The nature of the procedures to be used in the proposed treatment including their probable frequency and duration.

    (3) The probable degree and duration (temporary or permanent) of improvement or remission, expected with or without such treatment.

    (4) The nature, degree, duration and probability of the side effects and significant risks, commonly known by the health professions.

    (5) The reasonable alternative treatments and risks, and why the health professional is recommending this particular treatment.

    (6) That the patient has the right to accept or refuse the proposed treatment, and if he or she consents, has the right to revoke his or her consent for any reason at any time.

    California Health and Safety Code Section 1599.72

    No contract of admission shall include a clause requiring residents to sign a consent to all treatment ordered by any physician. Contracts of admission may require consent only for

    routine nursing care or emergency care. The admission contract shall contain a clause which informs the patient of the right to refuse treatments as set forth in paragraph (4) of subdivision (a) of Section 72527 of Title 22 of the California Administrative Code.

    Code of Federal Regulations, Title 42, Section 483.10(b)

    Resident rights.

    The resident has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. A facility must protect and promote the rights of each resident, including each of the following rights:

    (b) Notice of rights and services. (1) The facility must inform the resident both orally and in writing in a language that the resident understands of his or her rights and all rules and regulations governing resident conduct and responsibilities during the stay in the facility.

    The facility must also provide the resident with the notice (if any) of the State developed under section 1919(e)(6) of the Act. Such notification must be made prior to or upon admission and during the resident’s stay. Receipt of such information, and any amendments to it, must be acknowledged in writing;

    (2) The resident or his or her legal representative has the right–

    (i) Upon an oral or written request, to access all records pertaining to himself or herself including current clinical records within 24 hours (excluding weekends and holidays); and

    (ii) After receipt of his or her records for inspection, to purchase at a cost not to exceed the community standard photocopies of the records or any portions of them upon request and 2 working days advance notice to the facility.

    (3) The resident has the right to be fully informed in language that he or she can understand of his or her total health status, including but not limited to, his or her medical condition;

    (4) The resident has the right to refuse treatment, to refuse to participate in experimental research, and to formulate an advance directive as specified in paragraph (8) of this section;

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