Is “Against Medical Advice” Still Defensible? - Summary - MDSpire

Is “Against Medical Advice” Still Defensible?

A Viewpoint calls for more dignifying, harm-reduction–oriented hospital discharges for patients with OUD.

  • By

  • Kerri Miller

  • April 14, 2026

  • 3 min

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Objective:

To advocate for a collaborative and dignifying approach to hospital discharge for patients with opioid use disorder (OUD), particularly when they leave before treatment completion.

Approach:
    Key Findings:
    • Over 50% of postdischarge deaths in patients with OUD were attributed to overdose, not infection, when discharged against medical advice.
    • Oral antibiotic strategies are safe and effective for selected patients with barriers to prolonged intravenous therapy.
    • Stigmatizing language can undermine patient care and clinician engagement.
    Interpretation:

    The authors argue for a shift in discharge practices to prioritize patient dignity and safety, advocating for harm-reduction strategies and collaborative planning.

    Limitations:
    • The fragmented healthcare system may lack support for intensive wraparound services.
    • There may be no perfect solution for managing early discharges in OUD patients.
    Conclusion:

    Even when patients leave early, care can remain intentional, structured, and dignifying through proactive planning and supportive language.

    Sources:

Original Source(s)

Is “Against Medical Advice” Still Defensible?

  • by Kerri Miller

  • April 14, 2026

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