A 67-year-old patient refuses care and requests a release form. What is your best course of action?

The best course of action is to explain the risks. When a patient, particularly one who is elderly or may have diminished capacity, refuses care, it's essential to ensure that they are fully informed about the potential consequences of their decision. This involves articulating the medical risks they may face if they do not receive treatment, which may include deteriorating health or even life-threatening conditions, depending on their situation.

Taking this approach respects the patient's autonomy while ensuring they are aware of the implications of their refusal. It also serves as a way to protect yourself legally and ethically, demonstrating that you provided them with all necessary information before they made their decision.

Providing supportive care and allowing refusal is also a valid option, but it should ideally come after ensuring that the patient understands the risks involved, which is why explaining the risks takes precedence in this scenario. Restraining the patient or involving police for protective custody may be necessary in extreme cases where a patient poses a danger to themselves or others, but they are not the first actions to take if the situation allows for patient communication and education.