ArticleJournal of medical ethics2026
Respecting the right to refuse: is decision-making capacity disproportionately challenged in patients declining medical care in order to treat?
Article in Journal of medical ethics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to determine the proportion of capacity challenges for refusal of care, the risk factors that may trigger challenges to capacity and to consider the implications of challenging capacity.
methodsThis retrospective cohort study examined all psychiatric consults placed for decision-making capacity assessment over a 2-year period in an urban community hospital. Data were collected on the reasons for consultation, patient demographics and whether treatment occurred. Statistical analysis, including χ
results122 consults questioning capacity were identified during the 2-year period, of which 112 (91.8%) were placed in the setting of refusal of care. Males were over-represented (68.9%) in the consults placed for capacity assessment compared with the proportion of males in all hospital admissions (48.8%) (p<0.0001). The odds of being treated increased in the cohort of patients who lacked decision-making capacity compared with those who were deemed to have capacity (OR 4.2 (95% CI 1.4 to 10.4); p=0.002).
conclusionThis study shows that capacity is challenged overwhelmingly in patients declining medical care. When these patients are decentred from decision making, the odds of completing treatment were more than four times higher.
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