Patient dismissals

Dr. Agar,

I understand Australia is one country that doesn’t dismiss patients from a clinic like the U.S. does. I was wondering if you knew of other countries that don’t do dismissals?

P.S. I got my information from an Australian patient who posts by the name of RichardMEL, he posted the info at the following thread:

I am not prepared to ‘buy into’ this discussion.

Discord - for whatever reason - between patient and clinic is always complex, never black and white, and always most distressing and destablising for all concerned.

No generalisations are possible, and each case, with it’s underlying issues, is different.

It is, sadly, something that will inevitably occur from time to time, and given the vagaries of human nature and human cognition - irrespective of gender, race, creed or country.

No two cases are the same, and it is unwise for those who are not uniquely involved to pass comment on any single instance, no matter the circumstances.

That said, it behoves the caring team to attempt to resolve each case, on a case by case basis, with the interests of all parties in mind - the patient concerned, his/her relatives, all other patients in the unit, and the unit staff and the unit management. If the underlying dispute(s) cannot be resolved, then alternative care arrangements should be initiated, wherever possible.

That is all I am prepared to offer in response to your post.

Thank you for your reply, and I understand your position. However let me just state I don’t see much gray area here. In this country we don’t even deny dialysis to prisoners - and they have been convicted of a crime. I’ve watched this for 14 years and I’m convinced we have put assertive/questioning patients to death here. What has been going on is insane, believe RichardMEL in the above thread told us about the sane response in the case of a truly aggressive/violent patient. Sometimes black is black, and white is white.