AMA

• Only competent patients can leave AMA
  
  • No treatment guardian
    
  • Adult
    
    • Parents can remove child AMA but this may represent abuse/neglect and then they can’t – call Risk Management/CYFD/Police (STAT if emergency)
      
  • Not homicidal/suicidal/gravely disabled
    
  • Able to understand risks/benefits/alternatives
• Very high risk
  

  • 20% readmit rate @ 90 days
    
  • Often marginally competent
    
    • 35-50% psych patients AMA
      
    • High rate for alcohol/drug abusers
      
    • High rate for homeless
      
  • It may be easy to “prove” patient was incompetent after the fact (high malpractice risk)
• Do not let incompetent patients sign or leave AMA
• Call Risk Management ASAP