W. Va. Code R. § 64-59-8 - Right to Refuse Treatment
8.1. General. As a participant in the program planning process, the patient has the right to exercise a voice in his or her program plan and to object to or refuse aspects of the plan.
8.2. Use of Internal Discussion, Negotiation and Grievance Procedure. The patient's right to object to or refuse treatment is recognized as legitimate and shall be responded to in accordance with the provisions of the patient grievance procedure if informal discussion and negotiation do not resolve differences.
8.3. Alternatives Offered and Provided. The treatment team for any patient who has refused psychotropic medications or other recommended therapy shall meet and work to ensure that an agreed-upon effective alternative treatment is offered and provided if the patient consents.
8.4. Oral Refusal Overrides Prior Written Consent. An individual patient's oral refusal to accept medication or other treatment always overrides prior written consent except in emergency situations as defined in this rule or as required by the applicable standard of care.
8.5. Last Resort Procedure When Patient Refuses Treatment. In those instances when an involuntarily committed patient rejects any proposed treatment and all attempts at negotiating an acceptable alternative have failed, then the most conservative, least intrusive treatment approach that is acceptable under the applicable standard of care for the diagnosed condition and which produces minimal potential side effects may be imposed over the objections of the patient if all the following conditions are documented in the patient's medical record:
8.5.1. The patient's refusal is a product of his or her illness;
8.5.2. The proposed treatment is recognized as appropriate, effective and within accepted standards of practice;
8.5.3. The proposed treatment is approved by the clinical director;
8.5.4. The opinion of a second qualified practitioner concurs with the proposed treatment; and
8.5.5. The patient advocate is provided an opportunity to raise legitimate concerns on the part of the patient.
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