Acknowledge RIGHT
• You’re absolutely right. I mean you have every right to be involved in your own
treatment, and no one can force you to take any type of treatment.
• It’s our job as a doctor to go through the pros and cons and make sure you
understand and allow you to come to the conclusion yourself.
WHY refuse
• Do you mind telling me why you refuse the treatment
• Does the medication concern you in any way
o Side effect
o Worry about job
o Addiction
ACKNOWLEDGE concern
• I can see that your job is really important to you, and I can understand how you
think _____(e.g. low sugar level) because of the medication may cause problem
for you
• I can see how you may feel against this medication given that your friend had
all of those nasty s/e, I could completely see where you’re coming from
2ND HALF
RISK/implication
• The reason that we give _____(e.g. steroid) in this situation is that if we don’t
treat ____(e.g. Temporal arteritis) with _____, you could potentially lose your
vision
SOLUTION for both sides/NEGOTIATE
• I’m not 100% sure about the rules around this medication, maybe it’s okay, how
about I look into the rules for you. Maybe there are specific rules that allow for
this type of medication. Let’s look into it in more detail.
• Is there anyone that you know that might have more knowledge about this,
perhaps your bosses or someone at your work who look into this kind of things.
• This is not something I come across every day, let me talk to one of my seniors
about it. Perhaps there’s a way that we can work around this.
COMPETENT and STILL WANT TO GO HOME
• Ok I can see that you still wish to go, we can’t stop you as I explained earlier,
could we at least put in an alternative plan as I’m still worried about you?”
• Review the next day?
• Urgent clinic appointment
• Contact numbers
5. SELF-DISCHARGE (Comp