Patient neglect and abandonment occur when a patient does not receive adequate care, or when a care provider terminates the agreement without consent or notice. Healthcare professionals must avoid situations that could be considered neglect or abandonment. However, refusing to care for patients due to inability or warning patients of termination is not abandonment. Care providers must give ample notice or transfer care to another doctor. In emergency situations, care providers must find a qualified healthcare provider to take over and inform the patient.
Patient neglect is a form of neglect in which a patient receives no care or receives inadequate care. Several conditions must be present for a situation to be defined as abandonment in the legal sense. Healthcare professionals are usually careful to avoid situations that could be considered forms of patient neglect either because of their ethical obligations to care for patients or because they want to avoid legal liability.
When a care provider enters into an agreement to provide care to a patient and terminates the agreement without the patient’s consent and without giving adequate notice or making acceptable alternative arrangements, it is patient abandonment. For example, if a woman in labor enters the hospital and an obstetrician begins treating her and then leaves and does not return, the obstetrician may be responsible for abandoning the patient. Similarly, if the midwife left and sent a labor and delivery nurse when the woman clearly needed surgical care, that is also patient abandonment, because the patient is not being provided an adequate level of care.
If someone clearly needs medical care and that care is not being provided or someone is receiving medical care and a care provider stops, both of these situations are forms of patient neglect. A person who enters an emergency room requiring immediate treatment and does not receive it has been abandoned, just like a patient who is left in an emergency room by an ambulance crew who does not follow transfer protocol to ensure that a healthcare worker take care of the treatment was abandoned.
This does not mean that healthcare professionals cannot refuse to care for patients if they are unable to provide an adequate level of care. For example, a hospital with overcapacity might ask ambulance personnel to transport patients to another hospital, just as a hospital with a special needs patient might transfer that patient to a more appropriate facility. Similarly, a nurse can warn supervisors that she cannot work overtime or that her patient load is too high and no more patients can be added. This is not abandonment because the care provider has made it clear that care cannot be provided in advance.
Similarly, healthcare professionals can also stop treating patients without this being considered abandonment. To do this, the care provider must give patients ample notice or make arrangements to transfer care to another doctor. For example, doctors can warn patients that they are moving to another area or that a patient is violating study policies and that the doctor-patient relationship should be terminated. If a physician must immediately abandon a patient due to an emergency, grossly inappropriate behavior, ethical conflicts, or other issues, that physician is obligated to find a qualified healthcare provider to take over and inform the patient that someone else will be attending to his or her his care.
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