Going against medical advice

Against Medical Advice (AMA), sometimes also known as DAMA (Discharge Against Medical Advice), is a term used in healthcare institutions when a patient leaves the hospital against the advice of their doctor.

There is legal and ethical consensus in medical circles that mentally competent individuals can decline recommended treatment at their own will.Exercising your AMA right may seem reasonable in many circumstances.

But there are many factors that you must consider before unnecessarily putting yourself at undue risk.

Think carefully why you are taking an AMA stance. Are you making an objective decision? Have you fully understood your ailment, and the risks of ignoring advice? It may help to discuss things over with close family members before an AMA. Or even request an opinion from another physician. You make the final decisions though.

Despite your AMA rights, your doctor is not completely absolved of their responsibilities to your care. They must make sure you completely understand your medical condition, and the consequences of ignoring advice. It’s their duty to facilitate a safe transition to wherever you want to head, be it back home or to another facility. Above all, your doctor must deem you mentally competent when you insist on an AMA. Any doubts about your mental competency may provoke a review by another physician, or legal advice in conformity with enforceable medical restraint.

It is estimated that between 1 to 2 percent of patients leave medical facilities every year AMA. Majority do not come to any serious harm. But they leave the healthcare facilities before their treatment is complete, and some may often be in very unstable conditions. You are likely to return to the health institution much sooner once you leave AMA. Your risk of deteriorating to a much more precarious state continues to increase. And you face a real risk of death.

You will most likely be asked to sign a form declaring that you are leaving AMA. Hospitals are not necessarily legally obliged to request you to sign such a form. And you can decline to sign any forms and just leave anyway. Signing an AMA form is part of the documentation process about the circumstances surrounding your decisions to leave. It does not necessarily absolve any of the parties involved against future liabilities. You should never be forcefully restrained once you decide to leave, that would amount to unlawful imprisonment.

Think carefully when exercising your AMA rights. It doesn’t really matter if it is for inconsequential reasons. But you wouldn’t have made your way to the hospital for the sake of it. Your doctors will not be interested in keeping you in unless there was a good reason, usually some real risk to your life. But again, don’t let anybody stop you if you have a good reason to leave. Just be ready to accept the consequences your AMA actions.