When a patient refuses a recommended treatment, what is the first step you should take?

• A. Proceed with the recommended treatment to prevent delays.
• B. Explain the risks and benefits without asking about patient wishes.
• C. Acknowledge autonomy, explore reasons for refusal, present risks/benefits and alternatives, document the discussion, and respect the patient's final decision.
• D. Involve a supervisor before discussing the decision with the patient.

Answer: (C)

Respecting patient autonomy and informed consent is the first priority when a treatment is declined. The best approach is to acknowledge the patient’s right to refuse, ask about their reasons, clearly explain the risks and benefits of both accepting and declining the treatment, discuss any reasonable alternatives, document the discussion, and then honor the patient’s final decision. This sequence supports informed choice, preserves trust, and provides a record of what was discussed. Skipping discussion and proceeding anyway, or explaining risks without addressing the patient’s wishes, or escalating to a supervisor before talking with the patient, undermine autonomy and ethical practice.