Evaluation of persons that signed the signed against medical advice form at the emergency department of a Nigerian teaching hospital

Background: One of the ethical principles of medicine is autonomy, which allows the patient to make any decision concerning their health, whether beneficial or detrimental. One such decision that allows patients to exhibit the ethical principle of autonomy is when they decide to discharge themselves against medical advice. Usually, health facilities have a form that patients or their caregivers must append their signatures when they choose to sign against medical advice (SAMA). It becomes an ethical dilemma on who has the attorney to sign the SAMA form. Method: This is a cross-sectional study conducted at the accident and emergency department of the University of Port Harcourt Teaching Hospital to ascertain the persons who signed the SAMA form. Results: There were more males 361(52.5%) in this study than females and most of the patients that SAMA were conscious 655(95.3%) while 32(4.7%) were unconscious. Some of the patients refused to sign the SAMA form 138(20%). the majority of the persons that signed the SAMA somewhere not related to the patient. Conclusion: In Nigeria, due to the extended family system and communal style of living some persons who sign the SAMA form are not related to the patient. This puts both the physician and the person who signed the SAMA form at risk of litigation.