The human right to refuse medical treatment means that the patient is the legal authority in decisions about their care. It is grounded in the patient’s autonomy rights over their own body: You “own” your body and have the power to make all of the decisions about what will be done to it. When a patient hires or consults with a doctor, the doctor can assess the client’s condition and file, and make a recommendation. The patient has a right to consider the doctor’s recommendation, including an offer of surgery or another intervention, and say “Yes” or “No.” The right to say “No” is a human right. A patient’s decision to refuse medical treatment doesn’t have to be reasonable to the doctor, or anybody else. It is a personal decision, made on the basis of a variety of personal factors that can be known only to the patient. It may be that most patients choose to follow their doctors’ recommendations, to say “Yes.” But remember: Yes isn’t meaningful, unless you also have the right to say No. This means that you don’t have a legal obligation to walk into a hospital to receive treatment, and that you can walk out at any time. It means that nobody should perform an intervention on you without asking you first. It means that the birthing woman has the right to decline an offer of cesarean surgery or any other obstetric intervention. The person giving birth is the person best positioned to weigh their needs and options in combination with the needs of the unborn child in whom they are investing their womb, labor, and life force. In the complex ethical dynamic where there are two hearts (or more!) in one body – the heart that beats for them all, is the deciding heart. Shared decision-making is an admirable ambition for doctor-patient communication. Everybody wants to give birth with a provider they can trust. But in the event of a disagreement about what to do at a given moment in a birth, somebody holds the authority to make the final decision. Under the human right to refuse medical treatment, that person is the patient, making autonomy decisions about their body. The decision-maker in childbirth is the birthing woman.
