Capacity, Rationality, and the Promotion of Autonomy: A Trauma-Informed Approach to Refusals of Care After Opioid Poisoning

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This article refers to:

Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose

DISCLOSURE STATEMENT

Elaine Hyshka reports recent (past 5 years) receipt of peer-reviewed research grants from the Canadian Institutes of Health Research to study opioid-related emergency department care, and contracts from Alberta Health Services for scientific advising on harm reduction.

Notes

1 To maintain consistency with the target article, the authors of this commentary recommend a shift in the terminology used to “patient-directed discharge” (Eaton et al. 2020). “Against medical advice” represents a perspective on a behavior and is not patient centered. It is a form of paternalism justification that the authors of this commentary are bringing into question.

2 The singling out of any population (but particularly one already stigmatized and marginalized) for a more robust level of capacity assessment is also questionable. This requires a human rights analysis that is beyond the scope of this commentary.

Additional information

Funding

This work was undertaken, in part, thanks to funding from the Canada Research Chairs Program to Elaine Hyshka in the form of Canada Research Chair in Health Systems Innovation.