<unk>  <unk> , sometimes known as discharge<unk>  (DAMA), is a term used in health care institutions when a patient leaves a hospital against the advice of their doctor. While leaving before a<unk> ly specified endpoint may not promote the patient's health above their other values, there is widespread ethical and legal consensus that competent patients (or their authorized surrogates) are entitled to decline recommended treatment. The available data suggests that in general, patients discharged<unk>  have an increased risk of hospital readmission, and potentially death. This data however, describes groups of patients discharged<unk> , and therefore should not necessarily be applied to an individual patient wishing to leave<unk> , and who may have different clinical circumstances and risks. Although common hospital practice for an<unk>  discharge involves the patient being asked to sign a form stating that they are aware that they are leaving the facility<unk> , the hospital is generally not legally required to use it. Rather, the legal and ethical requirement is that the authorized health care professional has an informed consent discussion with the patient regarding their choice to leave the hospital before it has been recommended. This discussion which includes disclosure of the risks, benefits, and alternatives to hospitalization, as well as the patient's understanding, should be documented in the patient's chart. Many physicians incorrectly believe that insurance denies payment for the hospitalization of patients leaving<unk> , leaving such patients financially responsible. This "pervasive<unk>  urban legend'" may lead to ethical problems, as it "scares patients with misleading information" about their exposure to costs, leading to a "breakdown in the patient–doctor relationship" and an infringement of patient autonomy. Authors across numerous disciplines have begun to question the wisdom of the practice of designating a discharge as<unk> , as it doesn't follow professional standards, lacks evidence of its utility to improve patient care, and may harm patients by reducing their likelihood of following up. Finally, there is widespread ethical consensus that even when patients decline recommended treatment, health care professionals still have a duty to care for and support patients. The limited research in this area has led to a stagnation in effective interventions designed to alleviate<unk>  discharges. Multiple retrospective studies examining<unk>  discharges over the last 4 decades have attempted to identify risk factors in order to develop interventions to reduce the likelihood of<unk>  discharges in the future. The majority of studies have identified patient risk factors for<unk>  discharges that included low socioeconomic status, history of a substance use disorder, and male sex. No studies have yet attempted to identify physician factors that increase the risk of an<unk>  discharge. More research is needed to understand this practice and intervene effectively in a patient-centered fashion.
Against medical advice
Bonded medical place
Against Medical Advice
Contraceptive mandate
Private prescription
Accident
Contraceptive security
House call