In the example above, where an individual is refusing to take their medication, it would be best practice to try to encourage the individual to take it because this would be in their best interests. Everyone is different and by knowing the individual or referring to their care plan and risk assessments, we can establish the best techniques to help them to agree to take their medication.

For some individuals, this may mean simply leaving them for a while and then coming back later to offer them their medication again. Or even waiting for the individual to come to you to request it. For others, it may be necessary to explain the reasons why they should take their medication and the potential ramifications of them not taking it. You could even remind them of the negative consequences that occurred last time that they refused their medication.

Asking the individual why they are refusing their medication may shed some light on the reason for their refusal. It could be that they think the medication is causing them harm and in this case I would be able to reassure that it will help them, rather than harm them.

Sometimes, it may be necessary to ask for assistance from another member of staff as some individuals may be more willing to comply with a different person’s request.

If medication is still refused then I would contact a senior member of staff for advice. I may also obtain advice from the individual’s GP or NHS Direct (out of hours).

Recording the refusal of medication is imperative. I would note on the MAR sheet that medication had been refused and write up a statement about what had happened. It may be necessary for me to write up a risk assessment for the individual refusing their medication with collaboration from the individual, their family, other staff and other professionals, which can be used in the future.

Within my line of work, there are many times that there are conflicts or dilemmas between exercising my duty of care and the rights of an individual.

A typical example may be when an obese client wants to eat junk food or takeaways every day despite it being detrimental to their health. My duty of care obligations require me to encourage the client to have a healthy diet so that they don’t get poorly from overeating or not getting enough nutrition, however I also need to remember that all individuals have the right to make their own choices about what they eat.

Another example would be if an individual with paranoid schizophrenia refuses to take their medication. Everyone has the right to refuse medication and I should respect that, however my obligation to duty of care would require to do everything I can to try to encourage the individual to take it because I know that it would be detrimental to their mental health if they didn’t.