NFO Business of Medicine Web Series: The AMA Dilemma – Difficult Discussions and Documenting Your Defense

Patients who refuse recommended care or leave against medical advice (AMA) present complex clinical, ethical, and legal challenges for healthcare professionals across all practice settings. Balancing patient autonomy with safety obligations requires a clear understanding of informed consent and informed refusal, decision-making capacity, regulatory requirements, and effective documentation strategies. This program examines the ethical foundations of autonomy, the legal and regulatory framework governing informed consent and refusal, and the practical realities of assessing decision-making capacity in diverse patient populations. This activity also emphasizes application of best practices to everyday clinical scenarios, reinforcing the importance of clear communication, patient-centered decision-making, and high-quality documentation. Educational Objectives Upon completion of this activity, learners should be able to: 1. Discuss the competing interests of autonomy and safety. 2. Describe the foundation for informed consent. 3. Reinforce the informed consent/informed refusal process and documentation. 4. Identify what constitutes against medical advice (AMA). 5. Discuss “leaving AMA” prevention methods and documentation.