How should a PMU practitioner respond to a patient who refuses treatment?

• A. Persuade the patient to accept treatment
• B. Ignore the refusal
• C. Respect autonomy, provide information about consequences, offer alternatives if appropriate, and document the refusal and discussion
• D. Document refusal but take no further action

Answer: (C)

Respecting a patient’s autonomy while ensuring they’re informed is the key idea. When a patient refuses treatment, the best response is to acknowledge their decision, provide clear information about the consequences of not proceeding, discuss any reasonable alternatives if appropriate, and document both the refusal and the discussion. This approach supports informed decision-making, protects the patient’s rights, and creates a clear record for safety and accountability. Persuading the patient would cross into coercion and undermine autonomy. Ignoring the refusal or taking no action after it can expose the patient to unaddressed risks and fails to honor their right to choose. Documenting alone without a thoughtful discussion misses the opportunity to ensure understanding and explore alternatives.