Myth! Myth!
One myth that refuses to die is that patients who refuse a test or procedure Against Medical Advice (AMA) will be billed for all care up to that point, which their insurance company will not cover as a result of the refusal. Since shouting NOT TRUE! NOT TRUE! NOT TRUE! isn’t – or shouldn’t be – as persuasive as evidence, we incorporate a reference to published research in the cartoon itself, and provide this complete citation to the free full-text article:
G.R. Schaefer, et al., Financial Responsibility of Hospitalized Patients Who Left Against Medical Advice: Medical Urban Legend? J Gen Intern Med. 2012 Jul; 27(7): 825–830. https://doi.org/10.1007/s11606-012-1984-x
Should I sign the form?
Hospitals and health systems usually require patients to sign a form acknowledging that they are taking an action AMA, such as discharging themselves from care. This documentation protects the provider from liability in the event that some harm befalls the patient as a result of the refusal. However, a patient’s right to refuse treatment is not conditioned on their signature. In other words, there is no requirement under state or federal law that patients sign such a form.
Why the big deal?
Misconceptions are one thing. But willfully using falsehoods in order to override patient informed consent is quite another. If a health care provider has to resort to effectively threatening a patient with bankruptcy in order for the patient to consent to a course of treatment, then that provider is clearly not thinking of the patient’s best interests or rights. It is not very different from ensuring “compliance” by raising the specter of Child Protective Services intervention or playing the Dead Baby Card.
Takeaways
- It’s a myth! Patient refusal of a treatment or procedure will not cause a health insurance carrier to refuse coverage or payment.
- Providers who use this myth to attempt to coerce their patients are acting unethically and in violation of the laws of informed consent.
Image Credits
Frame 2.
- Photo of pregnant person and physician is by Bokskapet.
Frame 3.
- Photo of standing pregnant person is by Bokskapet.
- The superhero is part of a collection by geralt. She is wearing a gray mask by Satesh and a red mask by Oner. The Superman symbol outline is by Clipart Library and the cape is by Senior.
- The fetal monitor shown in the background is by HombreDHojalata.
- Photo of white-coated doctor is by PublicDomainPictures.
Mama's Got a Plan: 
