What should you do after a patient refuses a standing order medication?

• A. Respect autonomy after providing information; document refusal; consider medical control for risk.
• B. Ignore the refusal and administer anyway.
• C. Refuse care.
• D. Force the medication.

Answer: (A)

The main idea here is respecting patient autonomy and informed consent. When a patient is competent to decide, you must ensure they understand what the standing order medication does, including benefits, risks, and alternatives, as well as what happens if they refuse. If they still choose to refuse, you honor that decision rather than override it. After confirming understanding, you should document the refusal thoroughly—noting what was explained, the patient’s reason, the time, and who witnessed if possible. If there’s any risk of harm or if the patient’s condition could deteriorate, you should seek guidance from medical control to determine the appropriate next steps. You can also reassess if the patient’s condition changes or if they change their mind, but you do not administer the medication against their stated wishes, you do not force care, and you do not ignore the refusal.