Refusing to treat – is it legal? Is it justifiable? Is it ethical?




Hippocratic, destructive


Historically, when clinicians wanted to know if certain conduct was ethical, they would consult the guidelines set out in the Hippocratic oath. While adherence to the oath may “represent an expression of the professions’ ethical obligations”, and be useful in promoting their commitment to “abide by these norms”, this assumption is open to question.1 Different practitioners may see and interpret
the codes in different ways, depending on their personal ethos as well as the specific time and situation under consideration. At the same time, ethical material can and should reform, and when needed, be re written under optimal cool, calm conditions. Changes should be based on “contributions from those with a variety of perspectives who have access to as much available knowledge as
possible” and not implemented as a result of immediate pressures where there may be distorting circumstances.1 Perhaps the best way to judge their value is to debate how well the code addresses the issue at hand in terms of its “comprehensiveness, clarity and consistency”.1 This paper uses an actual patient scenario as a basis on which to pose some clinically and ethically related queries and postulate possible solutions.


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Author Biography

Angela M Harris


Freedman B. Health professions, codes, and the right to refuse to treat HIV infectious patients. Hastings Centre Report. 1988.18(2):suppl 20-25.

Mantel J. Refusing to treat noncompliant patients is bad medicine. Cardoza Law Review. 2017. Vol 39: 126-133.

Medical Protection Society. Removing patients from the practice list. Accessed at: Accessed on: 24-04-2023

Browne P. Refusal to treat: When is it ok to say “no”? Avant- Refusal to treat. 2015. Accessed at : Accessed on: 24-04-2023

Lippman H, Davenport J. Patient dismissal: The right way to do it: Under what circumstances is it permissible for a physician to “fire” a patient? J Family Prac; 2011;60(3)135-136

Brijnath B, Mazza D, Kosny A et al. Is clinician refusal to treat an emerging problem in injury compensation systems? BMJ Open 2016;6:e009423. Doi10.1136/bmjopen-2015-009423. Accessed on: 26-04-2023

Liang S. Should doctors be allowed to refuse to treat their patients?Accessedat: /article/view/ 701/668; Accessed on 01-05-2023.

Sandman L, Munthe C. Shared decision making, paternalism and patient choice. Health Care Anal. 2010;18(1):60–84. doi: 10.1007/s10728-008-0108-6

Derlet RW, Nishio DA. Refusing care to patients who present to an emergency department. Ann Emerg Med; 1990;19:262-267

Rischen RJ, Breuning KH, Bronkhurst EM, Kuijpers-Jagtman AM. Records needed for orthodontic diagnosis and treatment planning: A systematic review. 2013. Accessed at: Accessed on: 04-05-2023

Mizrahi E. Risk management in clinical practice. 2010. Part 7. Dento-legal aspects of orthodontic practice. British Dental Journal 209(8):381-390




How to Cite

Sykes, L., van Zyl, A. M., & Harris, A. M. (2023). Refusing to treat – is it legal? Is it justifiable? Is it ethical?. South African Dental Journal, 78(04), 217–219.