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- Title
An Alternative View of Self-Discharge Against Medical Advice: An Opportunity to Demonstrate Empathy, Empowerment, and Care.
- Authors
Machin, Laura L.; Goodwin, Dawn; Warriner, David
- Abstract
In this article, we present the experiences of discharging against medical advice from the perspectives of 17 hospital and community-based health care practitioners, and 16 patients, and relatives from a range of medical and surgical wards. Semistructured, in-depth interviews were conducted and thematically analyzed. We identified that practitioners, patients, and relatives frequently expressed empathy for each other during the interviews, and discharge against medical advice was presented as a way for patients to have control over their health. Contrary to predominantly negative framings that highlight increased mortality and morbidity, and portray people who discharge against medical advice as poor decision makers, we conclude discharge against medical advice can be framed positively. It can be an opportunity to empathize, empower, and care. We recommend that the vocabulary used in hospital discharge against medical advice policies and documents should be updated to reflect a culture of medicine that values patient autonomy, patient centeredness, and shared decision making.
- Subjects
ENGLAND; ATTITUDE (Psychology); DOCUMENTATION; EMPATHY; HOSPITALS; INTERVIEWING; LANGUAGE &; languages; RESEARCH methodology; MEDICAL personnel; RESEARCH funding; SELF-efficacy; QUALITATIVE research; PATIENT refusal of treatment; THEMATIC analysis; DISCHARGE planning; FAMILY attitudes; PATIENT autonomy; PATIENT decision making
- Publication
Qualitative Health Research, 2018, Vol 28, Issue 5, p702
- ISSN
1049-7323
- Publication type
Article
- DOI
10.1177/1049732318754514