The discharge of a patient against medical advice (AMA) represents a medical-legal risk. In general, the patient leaving AMA is in need of additional emergency medical care, or hospital admission. Since treatment is incomplete, presumably this patient group is at increased risk of medical complications, including disability or death. However, this is a difficult subject to study, and there is not a great deal of emergency medical literature on the subject.

In part, the concern over AMA discharges comes from defense attorneys and risk managers who litigate or manage malpractice cases, finding recurring problems with patients who leave AMA. The available medical and legal literature strongly suggest that emergency physicians (EP) should understand the increased risk of patient’s leaving AMA, and should be prepared to handle this difficult situation.