Right to Refuse Treatment

No. A form does not need to be signed for every no-show at pill line or for every time a patient refuses a medication. However, if the patient is repeatedly refusing, the responsible health authority would do well to have a policy to address follow-up such as provider notification and patient counseling.

— From CorrectCare Volume 25, Issue 2, Spring 2011

No, you cannot force an individual to have a test against his or her will (at least not without a court order). However, when an inmate’s refusal has possible public health consequences, you have to treat the situation differently. What staff in most facilities do is to tell inmates that if they refuse a screening test for a communicable disease, they will be segregated from the rest of the population. Until it can be determined whether the inmate is contagious or infectious, they cannot be allowed to mix with others. In our experience, when you provide this type of explanation, virtually everybody decides to comply.

— From CorrectCare Volume 23, Issue 3, Summer 2009

Any procedure requiring written consent in the community also requires a signed consent from an inmate in a correctional setting. Generally, written consent is required for any treatment or procedure that is invasive and carries some risk of an adverse outcome. Note, though, that not all health encounters require written consent. If the treatment/procedure is neither risky nor invasive, consent may be implied when the patient shows up for the health encounter. That said, if your facility wants to obtain written consent for every health encounter, it may do so. Standard J-I-05 Informed Consent and Right to Refuse Treatment addresses these issues in more detail.

— From CorrectCare Volume 17, Issue 2, Spring 2003; updated February 2010

Inmates have a right to refuse health evaluations and diagnostic testing as well as health treatment. Thus, NCCHC does not require that health staff continue to offer an inmate a routine history and physical on an ongoing basis. Barring other health problems for the inmate who refuses the intake history and physical, it is OK to wait until the next routine health evaluation is scheduled. That said, the frequency of such refusals should be very low. It would be prudent to document that the individual who refused the intake history and physical was counseled against doing so.

— From CorrectCare Volume 15, Issue 3, Summer 2001