Patients with substance use disorders (SUDs) being treated for serious medical conditions are more likely to leave the hospital against medical advice (AMA) than those without addiction. A special type of contract with healthcare providers might enable patients to consent in advance to life-saving medical care—even if they later refuse treatment, according to a commentary in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine (ASAM).
The Substance Use Advance Directive (SUAD) “has the potential to greatly improve the current state of treatment for life-threatening comorbid conditions in SUD patients through reducing AMA discharges,” writes Paul Tobias, MD, JD, MBA, of Ohio Health, Columbus.
But in an accompanying commentary, Kelly K. Dineen, JD, Ph.D., of Creighton University, Omaha, Neb., cites “obvious practical and ethical challenges” to the SUAD concept, including the lack of any legal basis for overruling patients