What is LAMA? The patient right at the centre of Sonam Wangchuk's hospital controversy

Leave Against Medical Advice (LAMA) has become a widely discussed medical term after it emerged in connection with activist Sonam Wangchuk's recent hospitalisation.

The Safdarjung Hospital Doctors Association has called for the protection of Wangchuk's right to avail LAMA while also seeking an independent inquiry into the circumstances surrounding his stay.

But what exactly does LAMA mean?

LAMA, or Leave Against Medical Advice, refers to a situation where a patient chooses to leave the hospital before doctors recommend discharge.

It is not a medical condition or a legal loophole. Instead, it is a patient's decision to decline further treatment despite medical advice to continue care.

Under the principle of patient autonomy, mentally competent adults generally have the legal and ethical right to refuse treatment or leave a healthcare facility.

Before doing so, hospitals typically explain the patient's condition, the recommended treatment, and the possible risks of leaving early. These risks may include worsening health, complications, or, in serious cases, death.

To document informed consent, hospitals usually ask the patient or an authorised attendantbto sign a LAMA form confirming they understand the potential consequences.

Patients opt for LAMA for several reasons. Financial constraints, a preference to continue treatment at another hospital, personal or family obligations, dissatisfaction with care, long waiting periods, or religious and personal beliefs can all influence the decision.

However, there are exceptions. Patients who are unconscious, lack decision-making capacity because of severe mental illness or cognitive impairment, or are subject to legal or public health restrictions may not be able to leave solely on their own request.

In such cases, decisions may involve legal guardians or applicable laws.