Against Medical Advice

Refusal, delay or limitation of traditional medical treatments, including vaccines, is an increasing phenomenon. With the desire to apply one's religion, culture or philosophy, treatment refusals are on the rise. Professionals working in social sciences, medicine, pharmacy, ancillary services as well as nurses in academic environments, professional settings and advanced practice roles can use this book as a resource to understand the complexity, diversity and profound impact of pediatric and adult treatment refusals, delays or limitations. Communication is the central thread throughout the book as the first step in safety is to assess the individual or families beliefs, culture or philosophical perspectives, understand the impact of these perspectives, share concerns with other healthcare team members, and seek a negotiation or safe outcome for all involved. This book provides the historical background, legal implications and ethical concerns when individuals or families either limit, refuse or delay traditional Western medical care based on their religious, cultural or philosophical beliefs. Findings from recent ethnographic research, clinical guidelines and latest technology are shared to provide examples of current refusal scenarios and to demonstrate the impact on those involved. This book is written for members of every discipline who are involved with pediatric and adult health care including in-patient, critical care, out-patient settings, home care, palliative care, and non-traditional or integral care practices. The center of the struggle is the well-being of the child and adult- no matter what process is utilized to reach treatment goals.