SEREMBAN - Doctors in government hospitals must obtain "informed consent" from patients wishing to be discharged before their treatment is over.
This is to protect the authorities from legal suits in the event complications arise, said Health director-general Datuk Dr Noor Hisham Abdullah.
Although an almost similar directive was issued in 1988, the previous guidelines were not fool-proof, he added.
He said a new circular outlining the do's and don't's on this had been issued to all state health departments and government hospitals and should be strictly complied with.
"It is important for medical personnel to abide by the new guidelines so that the hospital or the doctor cannot be held responsible if something goes wrong with a patient who decides to discharge himself," Dr Noor Hisham said in a directive.
"Although there are laws which give the authorities the powers to confine a sick person in hospital, the individual can still discharge himself, but this will be at his own peril."
Family members or guardians of in-patients can have them discharged against the doctor's orders, but this too would only be allowed after the necessary paperwork is done.
Dr Noor Hisham said medical personnel were duty-bound to explain the risks involved to in-patients bent on leaving treatment midway, and try their best to convince them to stay.
A patient allowed to leave after failure to dissuade him must first be stabilised.
If an in-patient with a communicable disease is discharged at his insistence, the hospital should notify the nearest district health office of his condition, Dr Noor Hisham said.
"This way, the medical authorities will still be able to monitor his condition and take remedial action if need be," he said, adding that an in-patient could be confined in a government hospital under the Prevention and Control of Infectious Diseases 1988, Mental Health Act 2001 and Child Act 2001.
He said doctors should record the reasons an in-patient gave for wishing to leave the hospital.
Dr Noor Hisham said patients who discharged themselves were still entitled to medication from government hospitals and be given follow-up appointments.
"The doctor can also use his discretion to issue medical leave to a patient who has discharged himself," he said.