When Patients Refuse Treatment

Informed refusal means the patient knows what could happen and the risks associated with not undergoing the recommended treatment, yet they still choose to refuse treatment. As an ND, there are responsibilities when a patient decides not to follow your recommendations.

Provider Responsibilities

As an ND, you are responsible for educating your patients about the potential risks and benefits of the treatment you provide. If a patient comes to your office after refusing traditional care for a life-threatening illness, such as cancer, you are not obligated to send them elsewhere. You are, however, obligated to share the risks associated with refusing these treatments.

As part of your informed refusal process:

  1. Make sure to educate your patient about the ramifications of refusing treatment.
  2. Document the conversation and ask the patient to sign an acknowledgement that you educated him or her about the risks of refusing the recommended treatment.
  3. Confirm the patient's history with the previous provider and find out whether the patient signed an informed refusal form. You may need the patient’s permission to obtain the previous provider’s records.
  4. Discuss with the patient both the potential risks of naturopathic treatment and the risks of not undergoing the recommended course of care.

The Benefits of Naturopathic Care for Your Patient

Patients likely came to you seeking noninvasive pain relief. Help them feel at ease by obtaining their informed consent.

  • Let patients know you will look out for their best interests and keep them informed about clinical treatment implications.
  • Explain both the common and uncommon side effects of naturopathic treatment.
  • Use simple language to make your informed consent process easily understood.
  • Share the potential benefits of your treatment plan. Help dispel patient fear by explaining how you plan to relieve pain through treatment.

Once you have gone through your treatment plan and obtained the patient’s informed consent, document everything. Keep a copy of the informed consent form in your patient’s records.

If you have provided educational materials during the informed consent process, include this with your documentation. (Note: the educational resource used, version number and publication date.) Check with your legal counsel as state and federal requirements may vary.


If you have questions about the informed consent or informed refusal processes, please call our Claims Advice Hotline at 800-242-4052.  

ND Insights is published for NCMIC policyholders. Articles may not be reprinted, in part or in whole, without the prior, express consent of NCMIC. Information provided in ND Insights is offered solely for general information and educational purposes. Names and events are created for illustrative purposes only. It is not offered as, nor does it constitute, legal advice or opinion. You should not act or rely upon this information without seeking the advice of an attorney.