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    Rights statement: The final, definitive version of this article has been published in the Journal, Qualitative Health Research, 28 (5), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the Qualitative Health Research page : http://journals.sagepub.com/home/qhr on SAGE Journals Online: http://journals.sagepub.com/

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An alternative view of self-discharge against medical advice: an opportunity to demonstrate empathy, empowerment, and care

Research output: Contribution to journalJournal article

Published
<mark>Journal publication date</mark>1/04/2018
<mark>Journal</mark>Qualitative Health Research
Issue number5
Volume28
Number of pages9
Pages (from-to)702-710
<mark>State</mark>Published
Early online date7/02/18
<mark>Original language</mark>English

Abstract

In this article, we present the experiences of discharging against medical advice from the perspectives of 17 hospital and community-based health care practitioners, and 16 patients, and relatives from a range of medical and surgical wards. Semistructured, in-depth interviews were conducted and thematically analyzed. We identified that practitioners, patients, and relatives frequently expressed empathy for each other during the interviews, and discharge against medical advice was presented as a way for patients to have control over their health. Contrary to predominantly
negative framings that highlight increased mortality and morbidity, and portray people who discharge against medical advice as poor decision makers, we conclude discharge against medical advice can be framed positively. It can be an opportunity to empathize, empower, and care. We recommend that the vocabulary used in hospital discharge against medical advice policies and documents should be updated to reflect a culture of medicine that values patient autonomy, patient centeredness, and shared decision making.

Bibliographic note

The final, definitive version of this article has been published in the Journal, Qualitative Health Research, 28 (5), 2018, © SAGE Publications Ltd, 2018 by SAGE Publications Ltd at the Qualitative Health Research page : http://journals.sagepub.com/home/qhr on SAGE Journals Online: http://journals.sagepub.com/