I DIDN'T FLINCH WHEN A clinic assistant recently brought me intake forms on a patient I was about to see, matter-of-factly noting, "FYI, she refused vitals." "Okay, thanks," I replied. Years of hearing and participating in conversations we have about patients, I later realized, had dulled my reaction. These conversations have become part of the fabric of our everyday work routines, whether on the wards, in team rooms, clinics, offices, and even outside hospital walls. To the layperson, a word like "refuse" might conjure up the notion of a cross-armed, defiant, and emphatic stance against something "reasonable" and "right."
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