Sometimes, if you’ve done your research and chosen not to go for a particular test or procedure, your health professional doesn’t take the news very well. Some professionals may try scare tactics like “Your baby will die” or “I’ll drop you as a patient” in order to get you to comply.
Rather than getting angry and frustrated, or worse, giving into pressure, try these 10 responses to a doctor who won’t take “no” for an answer:
1. “I don’t consent to that.”
Basic response. Rather than arguing or trying to prove you know what you’re talking about, just say this. Repeat as needed. This is especially helpful in a hospital setting, when they *can’t* drop you or make you leave and want to push something unnecessary on you right now.
2. “I’ll get back to you on that.”
This gives them a little hope that maybe you’ll change your mind, even if you won’t. You can always begin looking for other care (if you feel that refusing would cause a serious issue and/or you would be dropped for refusing) or call them later or go back when you have your husband or best friend or another “reinforcement.” This just saves an argument, although it doesn’t permanently end the situation.
3. “I understand it’s procedure, but based on this research, we feel this is the right choice for us.”
Print a couple of basic documents and bring them to your appointment if you know that refusing a particular test or procedure is going to be controversial, and let them know that this is why you are refusing. Some doctors may actually have not run across the information and may be interested to learn (even those who try hard to keep up simply can’t read everything!). Others, well, still won’t listen. But at least you feel confident because you have the reasons why you are making the decision in front of you.
4. “If the situation changes, we can discuss it again.”
No one is suggesting that you refuse tests or procedures that are medically necessary. It may reassure your doctor to know that if s/he feels that, given your individual situation, it was necessary, you would do the test/procedure. Hopefully this will keep the lines of dialogue open so that you receive the care you really need — and not just what’s “standard.”
5. “Thanks for the information and your educated opinion, but we will be making that decision.”
This recognizes that the doctor has provided valuable information, but that you are in charge of your body and your care. This can be coupled with “we’ll get back to you” if you feel uncomfortable saying no without your support person present.
6. “I have made my decision, and I don’t want to discuss it further at this time.”
This is a strong statement, for doctors who will not back off, even after you have tried other tactics. If you say this, then you have to stick by it. You may need to change the subject or leave the room. Stay with it, though. You don’t have to do anything you don’t want to.
7. “What are the alternatives to this procedure?”
Change tactics. Rather than arguing about the ‘recommended’ test or procedure, start asking about alternatives. You might ask follow up questions that are appropriate. For example, if you’re refusing the gestational diabetes test, you might say, “Could I check my blood sugar at home for a couple of days after meals? Could we stick with the urine tests and follow up only if we see glucose in my urine in concerning amounts?” You may also ask for the risks and benefits of these alternatives (which doctors ideally would provide you with anyway, but many don’t).
8. “This is against my personal/religious beliefs.”
Some people have strong moral or religious beliefs that prevent them from submitting to certain tests or procedures. For some women, it is literally against their religions. For others, they have a strong belief in the body carrying and birthing babies naturally, and tests or procedures that are not medically necessary interfere with these beliefs. Many doctors do not want to argue with beliefs, so this may be a route to take for some.
9. “I’m sorry, but I’m not going to do it.”
Be very clear. This is a final statement and might also be followed up with “I do not consent,” depending on the situation. It’s what you say when none of the above statements have helped. Your doctor isn’t willing to let you have time to decide, or come back to the discussion if and when there is a medical reason, and is not interested in your personal beliefs. His/her mind is made up that you need this test or procedure, no matter what, right now. This might make the doctor angry and you might get ‘fired’ from the practice. Stick to your guns and see the final point.
10. “We will be seeking care elsewhere. Thanks for your time.”
If you simply cannot see eye-to-eye, find someone else. There are other doctors and midwives out there and you may be better off with a different care model. Who wants to spend her entire pregnancy and birth fighting anyway? Even if you are fairly late in your pregnancy, you can still switch. Even if you’re in labor, you can still kick any doctor or nurse you don’t want out of your room and ask for a new one — it’s your right as a patient.
Remember, it is your body and your baby. You do not have to consent to procedures or tests that are not medically necessary or which make you uncomfortable. If you want all the screening tests, go for it! But if you don’t, and are not high risk of whatever (or don’t care to know, where applicable), you should not be forced into it. Say what you need to say and take a support person along if you want. Stand up for yourself! It’s worth it.
Have you ever had trouble refusing to consent? What did you say or do?
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