Script for politely declining a procedure
Saying no is part of clinical practice. The patient asks for a procedure that is not indicated, not safe or outside your competence, and the professional needs to decline without losing the relationship. The most common mistake is declining curtly or, at the other extreme, giving in out of awkwardness.
The script below helps you decline politely, offer an alternative and document it, all at the discretion of the licensed professional and following your professional board's rules.
Ready phrases
How do you document the refusal?
| Record field | What to note |
|---|---|
| Date and time | When the conversation took place |
| Patient's request | What they asked for, in their own words |
| Clinical assessment | What was observed, objectively |
| Reason for refusal | Clinical or safety reason |
| Guidance given | What was explained and proposed |
| Referral | Whether another professional or step was suggested |
When does a refusal become a clinic rule?
Some refusals repeat themselves (minors, contraindications, requests for guarantees). Having a standard text and a clinic policy avoids improvising and awkwardness. See how to say no to a patient in HOF, saying no to a patient with a contraindication and saying no to a request for a guarantee.
For the specific case where the request is something you do not recommend on technical grounds, see the script for when the patient asks for what you do not recommend.
Frequently asked questions
Can I decline a procedure even if the patient asks for it?
Yes, when there is no clinical indication or safety, or when the procedure falls outside your competence. The decision is the professional's, following your professional board's rules.
Do I need to document the refusal?
It is recommended. Note in the chart the request, the clinical reason and what was explained to the patient, with the date.
Can I refer them to another professional?
You can, when appropriate, without disparaging anyone. Referring politely keeps the relationship and protects the patient.
What should I do if the patient insists or gets angry?
Stay calm, repeat the reason clearly and offer an alternative. If necessary, end the conversation respectfully and record it.