Table 5.

Assessing Your Own Capacity: Eight Questions Providers Should Ask Themselves When a Patient Wants to Leave Against Medical Advice

Theme encountered when a patient wishes to leave AMA	Questions for self-reflection
Belief that the patient lacks insight into their medical conditions	1. Do I have full insight into this patient’s beliefs about health and illness?
	2. How can I use my insight to counsel this patient in a patient-centered way?
Suboptimal communication, mistrust, or conflict	3. What factors are making it difficult for us to communicate?
	What is it about:
	•This patient?
	•The system?
	•Me?
	4. How can I re-establish my trust in this patient and this patient’s trust in me?
Empathizing with the patient’s concerns	5. What are this patient’s concerns about remaining in the hospital?
	6. How can I acknowledge those concerns and communicate empathy and respect for this patient?
Professional roles and obligations towards the patient who wishes to leave AMA	7. How does this patient’s desire to leave make me feel about myself?
	8. How does this patient’s desire to leave make me feel about my professional responsibilities toward this patient?