The patient insisted to leave AMA (against medical advice).
The patient clinically not intoxicated, free from distracting pain, appears to have intact insight, judgment and reason and in my medical opinion has demonstrated capacity to make this medical decision. In this scenario, it would be battery to subject a patient to treatment against his/her will. I have voiced my concerns for the patient’s health given that a full evaluation and treatment had not occurred. I have discussed the need for continued evaluation to determine if their symptoms are caused by a condition that present risk of permanent disability, long term pain/suffering, development of morbidity which could in addition to cause suffering could require medical care or hospitalization that could be very costly, could cause problems which would prevent them from being able to work or care for themselves, and even lead to death. I tried offering alternative options in hopes that the patient might be amenable to partial evaluation and treatment which would be medically beneficial to the patient, though the patient declined my options and insisted on leaving. Because I have been unable to convince the patient to stay, I answered all of their questions about their condition and asked them to return to the ED as soon as possible to complete their evaluation/treatment regardless of how they feel but especially if their symptoms worsen or do not improve. I emphasized that leaving against medical advice does not preclude returning here for further evaluation and we would welcome their return to continue their evaluation at any time. I strongly encouraged the patient to return to this or any Emergency Department at any time if they are not willing to do so, at least to contact their PMD in hopes that the patient may at least have as much care to reduce risk to the extent that they are willing to do so.
_ was witness to this interaction and patient’s departure against my medical advice
_ were the risks of leaving verbalized by patient
_ Patient signed AMA form.
*This information is intended for educational purposes only and not intended for use in patient care (which requires a trained credentialed attending physician and individualization of the medical care plan to the specific patient).

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