Signing against medical advice: is it in the best interest of minors? - A case report.
Dabota Yvonne Buowari1*, Edward Ikpae1
1Department of Accident and Emergency, University of Port Harcourt Teaching Hospital, Rivers State.
*Correspondence: Dr. Dabota Yvonne Buowari; +234 803 732 4401; email@example.com
Download full article in pdf format
Background: Hospitalized patients leaving the hospital before being certiﬁed ﬁt to go occur in many countries and its prevalence varies globally. There are several reasons why patients discharge themselves against medical advice. Some hospitals ensure that the patient signs a form designed for this purpose to prevent any legal action of negligence.
Case Summary: A three-year-old boy sustained an injury while playing with resultant pain in the right forearm. He was taken to a traditional bone setter who applied some herbs and tied sticks around the aﬀected forearm. The patient developed gangrene when the sick was removed. He was taken to the hospital; but his caregivers then took a decision and signed against medical advice.
Conclusion: Discharge against medical advice is a global public health problem that needs to be addressed. It is worse when the decision is taken by a parent, guardian or relative/caregiver on behalf of a patient that cannot make a decision e.g., minors, unconscious patients and the mentally ill.
Keywords: Signing against medical advice, Caregivers.
Cite this article: Buowari DY, Ikpae E. Signing against medical advice: is it in the best interest of minors? – A case report. Yen Med J. 2020;2(1):186–189.
- Ndu IK, Asinobi IN, Ekwochi U. Discharge against medical advice (DAMA) among the paediatric age group in Enugu State University Teaching Hospital, Parklane, Enugu. J Experiment Res. 2016;4(1):55-62.
- Tabrizi J, Ranai A. Discharge against medical advice: an interventional study. Inter J Hosp Res. 2014;3(2):89-92.
- Gunchan P, Gunctam PL, Rubina K, Paul BS. Prospective evaluation of patients leaving against medical advice of a tertiary hospital: comparison of emergency and intensive care units. Int J Med Pub Health. 2018;8(1):18-23.
- Jimoh BM, Obalim-Chris A, Igwilo C, Adewumi O, Aremu G, Adamu H et al. Prospective evaluation of cases discharged against medical advice in Abuja, Nigeria. Sci World J. 2015:314817-5. doi: 10.1155/2015/314817.
- Wong TW, Lee KM, Chan R, Lau CC. A study of patients who leave an accident and emergency department against medical advice. Hong Kong J Emerg Med. 2000;7:22-26.
- Ayed IA. What makes patients leave against medical advice? J Taibah Uni Med Sci. 2009;4(1):16-22.
- Fadare JO, Babatunde OA, Olarewaju T, Busari O. Discharge against medical advice: experience from a rural Nigerian Hospital. Ann Nig Med. 2013;7(2):60-65.
- Baptist AP, Warrier I, Arora R, Ager J, Massanari MR. Hospitalized patients with asthma who leave against medical advice: characteristics, reasons and outcomes. J Allergy Clin Immunol. 2017;119:924-929.
- Feras HA, Farooq M, Elshehry AF, Hassan MA, Jawaid RF. The rate and reasons for discharge against medical advice. Bahrain Med Bull. 2017;39(3):140-145.
- Malek VAE, Alexander S, Anezi FA. Discharge against medical advice among children admitted into paediatric wards at Al-Jahra Hospital, Kuwait. Kuwait Med J. 2014;46(1):28-31.
- Nasir AA, Babalola MO. Clinical spectrum of discharges against medical advice in a developing country. Indian J Surg. 2008;70:68-72.
- Alfandre DJ. ‘I’m going Home’ discharges against medical advice. Mayo Clin Proc. 2009;84(3):255-260.
- Ndukwu CU, Ogbuagu CN, Ihegihu CC, Ugezu AI, Chukwuka CN. Discharge against medical advice amongst Orthopaedic patients in Nnewi, South-East Nigeria and its public Health implications. Orient J Med. 2014;26(1):9-15.
- Adel Y. Factors associated with discharge against medical advice in a Saudi teaching Hospital. Jaibah Uni Med Sci. 2012;7(1):13-18.
- Ahmed LA, Akinboye O, Ilesanmi OS, Adeleke O, Olatunde L, Udonwa N. Determinants of discharge against medical advice in a tertiary hospital in a semi-urban area of south-western Nigeria. Inter J Caring Sci. 2015;8(3):519-529.
- Akinbodewa AA, Adejumo OA, Adejumo OA, Adebayo FY, Akinbodewa GO, Alli EO, Benson MA. Evaluation of administration of discharge against medical advice: Ethico- legal considerations. Nig Postgrad Med J. 2016;23:141-145.
- Onyiriuka AN. Paediatric discharge against medical advice, experience from a Nigerian secondary healthcare institution. Med J Islamic Rep Iran. 2011;25(4):194-199.
- Aliyu I, Lawal TO. Signing against medical advice in a special care baby unit in a tertiary centre in North-Western Nigeria. Trop J Med Res. 2017;20:16-19.
- Duru CO, Peterside O, Ududua AO. Paediatric discharges against medical advice at a tertiary centre in Bayelsa State, Nigeria. Nig J Paed. 2014;4(2):90-95.
- Saia M, Buja A, Mantoan D, Bertoncello C, Baldovin T, Callegaro G, Baldo V. Frequency and trends of hospital discharges against medical advice (DAMA), in a large administrative database. Ann Ist Super Sanita. 2014;50(4):357-362.
- Hayat AA, Ahmed MM, Minhas FA. Patients leaving against medical advice: an inpatient psychiatric hospital-based study. J Coll Physic Surg Pak. 2013;23(5):342-346.