The patient's right to refuse medical care: legal and ethical analysis

This article addresses the pressing issue of the patient's right to refuse medical treatment as a fundamental legal and ethical phenomenon in modern healthcare. It examines the relationship between patient autonomy and the physician's duty to provide care, as well as the balance between the principles of beneficence, non-maleficence, and justice in the context of medical practice. The work provides a comprehensive analysis of international legal instruments (the Council of Europe Convention on Human Rights and Biomedicine, the UNESCO Universal Declaration on Bioethics and Human Rights, the Lisbon Declaration on the Rights of the Patient), the case law of the European Court of Human Rights, and the legislation of leading democratic states (the United States, Germany, France, and Poland). The article examines the historical evolution of this right, judicial precedents (cases such as In re Quinlan, Cruzan v. Director, Missouri Dept. of Health, and others), mechanisms for its implementation, including the institution of advance directives and end-of-life decision documents. A bioethical analysis is conducted, which demonstrates the inextricable link between the right to refuse treatment and the principles of human dignity and personal autonomy. The article establishes an understanding of how different legal systems resolve the conflict between the patient's will and the physician's professional duty. Critical conditions for the exercise of this right are identified: patient capacity, information, voluntariness of decision, its documentation, and consistency with public interests. Based on comparative legal analysis, recommendations are formulated for improving the legal regulation of this issue in Ukraine, in particular regarding the adoption of a modern law on patients' rights, legal recognition of advance directives, and the development of palliative care culture. The work emphasizes the necessity of forming a model of dialogue-based medicine, where decisions are made jointly by the physician and patient on the basis of respect for the patient's autonomy.

patient's rights; human rights; informed consent; autonomy; medical law; bioethics; palliative care; advance directives; right to refuse treatment; human dignity; self-determination