Discharging Patients against Medical Advice

This Clinical Decisions feature presents the case of a 35-year-old man with intravenous heroin use disorder and suspected right-sided endocarditis who wishes to leave the hospital after initial symptom relief. Two perspectives are explored: one advocating for documentation of discharge as “against medical advice” (AMA), citing legal protections and clarity in clinical decision-making; the other arguing against AMA labeling due to its potential to stigmatize patients, deteriorate the therapeutic relationship, and obscure systemic care challenges. The article invites readers to weigh both viewpoints when documenting discharges in similar clinical scenarios.

This Clinical Decisions feature presents the case of a 35-year-old man with intravenous heroin use disorder and suspected right-sided endocarditis who wishes to leave the hospital after initial symptom relief. Two perspectives are explored: one advocating for documentation of discharge as “against medical advice” (AMA), citing legal protections and clarity in clinical decision-making; the other arguing against AMA labeling due to its potential to stigmatize patients, deteriorate the therapeutic relationship, and obscure systemic care challenges. The article invites readers to weigh both viewpoints when documenting discharges in similar clinical scenarios.