Refus de traitement : aider le malade à mieux se comprendre

A patient's refusal to undergo treatment may leave carers facing the apparently insoluble dilemma of reconciling the principle of autonomy and the principle of beneficence. Respecting the patients' personal freedom could lead to leaving them to their fate, whereas wanting to look after them could mean caring for them against their will. Adopting a more understanding attitude seems necessary to lighten this unbearable tension. Trying to understand together with the patients the reasons for their decisions may help them make an informed choice, and then perhaps they may reconsider their conclusion. However carers must be careful not to turn patient care into harassment in order to make them change their minds at all cost. Caregivers must also learn how to respect people's refusal of the good they would like to be permitted to do.