Evaluation of persons that signed the signed against medical advice form at the emergency department of a Nigerian teaching hospital
Article Sidebar
Main Article Content
Abstract
Background: One of the ethical principles of medicine is autonomy, which allows the patient to make any decision concerning their health, whether beneficial or detrimental. One such decision that allows patients to exhibit the ethical principle of autonomy is when they decide to discharge themselves against medical advice. Usually, health facilities have a form that patients or their caregivers must append their signatures when they choose to sign against medical advice (SAMA). It becomes an ethical dilemma on who has the attorney to sign the SAMA form.
Method: This is a cross-sectional study conducted at the accident and emergency department of the University of Port Harcourt Teaching Hospital to ascertain the persons who signed the SAMA form.
Results: There were more males 361(52.5%) in this study than females and most of the patients that SAMA were conscious 655(95.3%) while 32(4.7%) were unconscious. Some of the patients refused to sign the SAMA form 138(20%). the majority of the persons that signed the SAMA somewhere not related to the patient.
Conclusion: In Nigeria, due to the extended family system and communal style of living some persons who sign the SAMA form are not related to the patient. This puts both the physician and the person who signed the SAMA form at risk of litigation.
Downloads
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
Share
References
Muftau Jimoh B, Anthonia OC, Chinwe I, Oluwafemi A, Ganiyu A, Haroun A, Chinwe E, Joshua A. Prospective evaluation of cases of discharge against medical advice in Abuja, Nigeria. The Scientific World Journal. 2015;2015(1):314817.
Lee CA, Cho JP, Choi SC, Kim HH, Park JO. Patients who leave the emergency department against medical advice. Clinical and experimental emergency medicine. 2016 Jun;3(2):88.
Abuzeyad FH, Farooq M, Alam SF, Ibrahim MI, Bashmi L, Aljawder SS, Ellouze N, Almusalam A, Hsu S, Das P. Discharge against medical advice from the emergency department in a university hospital. BMC emergency medicine. 2021 Dec;21:1-0.
Alidoust F, Yahyavi ST. Exploring the inner roots of discharge against medical advice (DAMA) in an academic psychiatric hospital: a qualitative study. Middle East Current Psychiatry. 2022 Sep 15;29(1):70.
World Health Organization. WHO compendium of innovative health technologies for low-resource settings 2024. World Health Organization; 2024 Jul 18.
Adefemi SA, Adeleke IT, Gara P, Ghaney OO, Omokanye SA, Yusuf AM. The rate, reasons and predictors of hospital discharge against medical advice among inpatients of a tertiary health facility in Northcentral Nigeria. American Journal of Health Research. 2015;3(1):11-6.
Muftau Jimoh B, Anthonia OC, Chinwe I, Oluwafemi A, Ganiyu A, Haroun A, Chinwe E, Joshua A. Prospective evaluation of cases of discharge against medical advice in Abuja, Nigeria. The Scientific World Journal. 2015;2015(1):314817.
Akinbodewa AA, Adejumo OA, Adejumo OA, Adebayo FY, Akinbodewa GO, Alli EO, Benson MA. Evaluation of administration of discharge against medical advice: Ethico-legal considerations. Nigerian Postgraduate Medical Journal. 2016 Jul 1;23(3):141-5.
Olasinde YT, Alao MA, Agelebe E. Discharge against medical advice from a Mission tertiary hospital, SouthWest, Nigeria. Nigerian Journal of Clinical Practice. 2020 Oct 1;23(10):1333-8.
Ahmed LA, FMCFM F. Determinants of discharge against medical advice in a tertiary hospital in a semiurban area of South-Western Nigeria. International Journal of Caring Sciences. 2015 Sep 1;8(3):519.
Babatola AO, Olatunya OS, Ogundare EO, Ajibola AE, Ojo TO, Oluwayemi IO, Ajite AB, Adeniyi AT, KomolafeAK, Fadare JO, Oyelami OA. Pediatric discharges against medical advice: a review of cases in Ado-Ekiti, Nigeria. Journal of Comprehensive Pediatrics. 2021;12(3).
Oyira EJ, Mgbekem M, Edet OB. Factors associated with discharge against medical advice among patients in University of Calabar Teaching Hospital Calabar (UCTH). Global Journal of Pure and Applied Sciences. 2016 Oct 13;22(1):91-100.
Heydari M, Khosra VI, Zadeh O, Kalhor R, Sharifi M, Ghasab AA. Discharge against medical advice in a teaching hospital: a telephone survey. Client Centr Nurs Care. 2017, 3(4), 277-282
Gunchan P, Gautam PL, Rubina K. Prospective evaluation of patients leaving against medical advice of a tertiary care hospital: omparison of emergency and intensive care units. International Journal of Medicine and Public Health. 2018;8(1).
University of Port Harcourt Teaching Hospital standard operating procedures (SOP). Maiden edition. 2019 produced by: the servicon unit of the University of Teaching Hospital.
Eze B, Agu K, Nwosu J. Discharge against medical advice at a tertiary center in southeastern Nigeria: sociodemographic and clinical dimensions. Patient Intelligence. 2010 Sep 2:27-31.
Al Ayed I. What makes patients leave against medical advice?. Journal of Taibah University Medical Sciences. 2009 Jan 1;4(1):16-22.
Lakhotia AN, Sodani A, Dube M, Telang K, Jain R, Athale S. Discharge against medical advice from neurology wards of a teaching hospital: A prospective observational study. Clinical Epidemiology and Global Health. 2019 Mar 1;7(1):115-20.