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You have certain rights in the hospital, one of which includes the right to leave the hospital when you want to. This is true even if your healthcare provider wants you to stay. It is called being discharged against medical advice (AMA).
The right isn't absolute, however, and there are situations where a hospital can force you to stay. This includes having a legal guardian whose decisions override yours, being legally declared incompetent, or being incarcerated (in prison).
This article looks at when you do and don't have the right to leave the hospital by your own choice.
The typical hospital most people think of is an acute-care hospital. This is where you go for surgery and other scheduled procedures as well as for emergency treatment and unscheduled procedures.
Other hospitals are intended for longer-term care, often for rehabilitation after surgery or a serious injury. These are called long-term acute or subacute hospitals.
If you are in either type of hospital, you generally have a right to leave whenever you wish. Medical personnel cannot keep you against your will.
But the right isn't absolute.
To be discharged AMA, you will be asked to sign a form stating that you wish to leave even though your healthcare provider thinks it's a bad decision. The signature waives your right to sue for complications arising from the early discharge. Thus, the hospital will be held harmless for any problems you have after leaving the building.
While a healthcare provider can strongly advise against the discharge, they cannot stop you or threaten you in any way. This includes suggesting that your insurance company can refuse payment of some or all of your bill if you are discharged AMA. This is generally not true.
A study conducted by the Pritzker School of Medicine found that, after assessing nine years of medical records of 46,319 patients hospitalized in 13 Illinois hospitals, there was not one instance where an insurer denied payment due to an AMA discharge.
In short, you have the right to leave the hospital without paying your bill. Whether you have paid or not has no impact on your right to make a medical decision. Additionally, you may leave without signing the discharge form. The healthcare provider would still consider this as leaving against medical advice.
The same applies if you have just given birth. Though you may be advised to stay 24 to 48 hours after delivery, no one can legally stop you if you want to leave early. The hospital will almost invariably want to evaluate you and your baby earlier than the typical waiting period after birth, but even then cannot demand it.
In the same way that you have to right to leave early, you also have a right to refuse discharge if you think you're being released too soon. You would need to lodge an appeal with the hospital and possibly pay more (in terms of co-pays, deductibles, and co-insurance costs), depending on what your insurer agrees to cover.
There are situations where you don't have the right to check yourself out of the hospital. This is usually because someone else is legally responsible for you.
You may lose the right to an early hospital discharge if you're declared incompetent by a court of law. That can happen if you have a serious psychiatric problem or substance abuse problem that puts you or others in harm's way. Moreover, a healthcare provider must legally declare that you're a threat to yourself or others.
The hospital or an individual such as a spouse or family member will need to petition the court. If the court agrees, you can be temporarily committed.
Thereafter, medical decisions are no longer in your control until the court decides that you are competent to make your own decisions.
If granted the right by a court of law, a hospital can hold you for a maximum of 72 hours. The most common reason for this is when a person is in a grave condition or in immediate danger to themselves or others.
If you have a legal guardian, only they have the right to request an AMA discharge. For children, this usually means their parents.
It is only until you reach the age of emancipation that your parents no longer have the right to direct your medical decisions. In most states, the age of emancipation is 18. The exceptions are Alabama and Nebraska, where the age of majority is 19, and Mississippi and Puerto Rico, where it is 21.
Some adults also have legal guardians. One is often appointed for adults with special needs who have difficulties making their own decisions. In such cases, the guardian can request the AMA and is responsible for signing the paperwork.
Your rights are different if you're hospitalized while in the custody of law enforcement. In such cases, you are not free to go whenever you want. Only the correctional facility holding you can authorize an AMA discharge. However, you do have the right to refuse medical care.
With that said, a legal appeal can be lodged on your behalf by someone who you appoint as your surrogate. This may include a family member, a non-incarcerated friend, or a specific clinician at the correctional facility.
Even so, from a legal perspective, it may be easier to request a delayed discharge for medical reasons rather than an early discharge.
You can usually discharge yourself AMA. However, you must waive your right to sue for anything that happens after you leave.
You cannot leave AMA if you're legally someone else's responsibility. Only the legally responsible party can make an early discharge decision.
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By Trisha Torrey
Trisha Torrey is a patient empowerment and advocacy consultant. She has written several books about patient advocacy and how to best navigate the healthcare system.
