Opinion ID: 2402992
Heading Depth: 2
Heading Rank: 1

Heading: The Right to Refuse Treatment

Text: The common law recognizes the right of individual autonomy over decisions relating to one's health and welfare. [11] From this root of autonomy, the common law developed the principle that a battery occurs when a physician performs a medical procedure without valid consent. Hershley v. Brown, 655 S.W.2d 671, 676 (Mo.App.1983). The doctrine of informed consent arose in recognition of the value society places on a person's autonomy and as the primary vehicle by which a person can protect the integrity of his body. If one can consent to treatment, one can also refuse it. Thus, as a necessary corollary to informed consent, the right to refuse treatment arose. The patient's ability to control his bodily integrity... is significant only when one recognizes that this right also encompasses a right to informed refusal. Conroy, 486 A.2d at 1222. A decision as to medical treatment must be informed. There are three basic prerequisites for informed consent: the patient must have the capacity to reason and make judgments, the decision must be made voluntarily and without coercion, and the patient must have a clear understanding of the risks and benefits of the proposed treatment alternatives or nontreatment, along with a full understanding of the nature of the disease and the prognosis. Wanzer, Adelstein, Cranford, Federman, Hook, Moertel, Safar, Stone, Taussig & Van Eys, The Physician's Responsibility Toward Hopelessly Ill Patients, 310 New Eng. J. Med., 955, 957 (1984). In the absence of these three elements, neither consent nor refusal can be informed. Thus, it is definitionally impossible for a person to make an informed decisioneither to consent or to refuseunder hypothetical circumstances; under such circumstances, neither the benefits nor the risks of treatment can be properly weighed or fully appreciated.