[The patient refuses treatment. What to do now?]

Abstract

Treating a patient requires his or her informed consent. The Dutch Medical Treatment Contracts Act (WGBO), however, contains three exceptions in which cases permission from the patient is not required. In emergency cases a physician is allowed to treat an incompetent patient, even against his or her will. The treating physician can both be a general physician or an emergency physician in a hospital considering to treat a patient against serious somatic injuries or threats. As long as the patient is incompetent and the emergency situation continues a physician is not required to invite the crisis intervention team to assess the competence of the patient and the potential harm the patient's condition may cause under the Compulsory Mental Healthcare Act (WVGGZ). In fact, more care may be provided than initially considered essential to save the life of the patient as long as the emergency situation lasts. However, the longer the emergency situation exists, the more necessary it becomes to involve the crisis intervention team and ask for a crisis measure for the patient under the WVGGZ.