When a patient refuses treatment, which actions are appropriate?

• A. Proceed with treatment regardless of refusal
• B. Respect their choice; Ensure they understand the risks; Record the refusal in notes
• C. Ignore the refusal and reschedule
• D. Postpone indefinitely

Answer: (B)

When a patient refuses treatment, the essential approach is to respect their autonomy while ensuring the decision is informed. This means confirming that they understand the risks of not proceeding, any alternatives, and the potential consequences for their oral health. If they are capable of making the decision and choose to refuse, acknowledge their choice, document the refusal clearly in their notes with details of what was refused, what information was provided about risks, and the date and who was present. It’s also good practice to offer to discuss it again later and to ensure there was no pressure or coercion influencing the decision. Proceeds without consent, ignoring the refusal, or postponing indefinitely without documenting an informed discussion are not appropriate because they undermine patient autonomy and legal/ethical standards for consent.