Treatment refusal in a rootless individual with medical problems.

A multidisciplinary case conference was held concerning an elderly woman who was hospitalized repeatedly because of progressive cardiac and pulmonary disease. The patient was unable to understand her illness and did not comply with the treatment regimen. The case demonstrates the usefulness of the multidisciplinary approach and the complexities of caring for someone who does not accept treatment. The dilemma is in how to preserve an individual's freedom and right to refuse treatment when organic impairment and past history interfere and pose a threat to health.