Patient abandonment is a form of neglect in which a patient is not provided with care or is provided with inadequate care. Several conditions must be present for a situation to be termed abandonment in the legal sense. Care providers are usually careful to avoid situations which might be considered forms of patient abandonment both because of their ethical obligations to care for patients and because they want to avoid legal liability.
When a care provider enters into an agreement to provide care for a patient and terminates the agreement without the consent of the patient and without giving proper warning or making acceptable alternative arrangements, this is patient abandonment. For example, if a laboring woman enters a hospital and an obstetrician starts treating her and then leaves and does not return, the obstetrician can be liable for patient abandonment. Likewise, if the obstetrician left and sent in a labor and delivery nurse when the woman was clearly in need of surgical attention, this is also patient abandonment, because the patient is not being provided with an appropriate level of care.
If someone is clearly in need of medical care and that care is not provided or someone is receiving medical care and a care provider stops, both of these situations are forms of patient abandonment. A person entering an emergency room who requires immediate treatment and does not receive it has been abandoned, just as a patient who is left in an emergency room by an ambulance crew which does not follow transfer protocol to ensure that a care provider is taking over treatment has been abandoned.
This does not mean that care providers cannot refuse to care for patients if they cannot provide an adequate level of care. For example, a hospital which is over capacity might ask ambulance crews to transport patients to another hospital, just as a hospital with a special needs patient might transfer that patient to a more appropriate facility. Likewise, a nurse can warn supervisors that he or she cannot work overtime hours, or that her or his patient load is too high and no additional patients can be added. This is not abandonment because the care provider has made the fact that care cannot be provided clear in advance.
Likewise, care providers are also allowed to stop treating patients without it being considered abandonment. In order to do so, the care provider must provide patients with ample advance warning, or make arrangements to transfer care to another physician. For example, physicians can warn patients that they are relocating to another area or that a patient is violating the policies of the practice and that the doctor-patient relationship must be terminated. If a doctor must drop a patient immediately because of an emergency, grossly inappropriate behavior, ethical conflicts, or other issues, that doctor is obliged to find a qualified care provider to take over and to notify the patient that someone else will be handling his or her care.
