The Importance of a Proper Against-Medical-Advice (AMA) Discharge: How Signing Out AMA May Create Significant Liability Protection for Providers

Abstract Background Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. Objective The goal of this article is to explain the potentia...

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Published in:	The Journal of emergency medicine Vol. 43; no. 3; pp. 516 - 520
Main Authors:	Levy, Frederick, MD, JD, Mareiniss, Darren P., MD, JD, Iacovelli, Corianne, JD
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-09-2012
Subjects:	against medical advice AMA assumption of risk capacity disclosure Disclosure - legislation & jurisprudence Documentation duty Emergency Emergency Service, Hospital - legislation & jurisprudence Humans liability Liability, Legal malpractice Malpractice - legislation & jurisprudence Mental Competency - legislation & jurisprudence negligence Patient Discharge - legislation & jurisprudence protections Risk Management Treatment Refusal - legislation & jurisprudence United States United States disclosure assumption of risk AMA negligence liability duty protections against medical advice malpractice capacity
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Abstract	Abstract Background Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. Objective The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge. Discussion In this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication. Conclusion The authors conclude that a properly executed discharge can provide significant legal protection from liability risks.
AbstractList	Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge. In this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication. The authors conclude that a properly executed discharge can provide significant legal protection from liability risks. Abstract Background Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. Objective The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge. Discussion In this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication. Conclusion The authors conclude that a properly executed discharge can provide significant legal protection from liability risks. Background:Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications. Objective: The goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge. BACKGROUNDEvery year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many of these patients are at risk of subsequent complications.OBJECTIVEThe goal of this article is to explain the potential legal protections that may be created from a proper AMA discharge.DISCUSSIONIn this article, the authors review the steps that need to be taken when performing an AMA discharge, including an assessment of capacity, proper documentation, and adequate disclosure. The authors then review the potential legal protections that can result from a properly documented and performed discharge. Among these protections are: proof that the provider's duty to the patient ended with discharge and that the patient assumed the risk of a subsequent complication.CONCLUSIONThe authors conclude that a properly executed discharge can provide significant legal protection from liability risks.
Author	Mareiniss, Darren P., MD, JD Levy, Frederick, MD, JD Iacovelli, Corianne, JD
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Snippet	Abstract Background Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is... Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known that many... BACKGROUNDEvery year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well known... Background:Every year, patients leave the Emergency Department against medical advice (AMA) and before an adequate evaluation can be performed. It is well...
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SubjectTerms	against medical advice AMA assumption of risk capacity disclosure Disclosure - legislation & jurisprudence Documentation duty Emergency Emergency Service, Hospital - legislation & jurisprudence Humans liability Liability, Legal malpractice Malpractice - legislation & jurisprudence Mental Competency - legislation & jurisprudence negligence Patient Discharge - legislation & jurisprudence protections Risk Management Treatment Refusal - legislation & jurisprudence United States
Title	The Importance of a Proper Against-Medical-Advice (AMA) Discharge: How Signing Out AMA May Create Significant Liability Protection for Providers
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