Refusal, withdrawal and avoiding pressure

A person can refuse or withdraw consent at any point. This includes saying no to an optional scan, an add-on product, a frame choice, a measurement, a photograph, sharing information, a support task or continuing a process that has already begun.

Respecting refusal does not mean leaving the person unsupported. It means listening, checking whether clearer information or support would help, explaining practical consequences that fall within your role, and involving the appropriate colleague when refusal raises clinical, safeguarding or safety concerns.

When refusal should be respected

If the person appears capable of deciding, understands the practical choice and is not under pressure, their refusal should normally be respected. They are not required to make the choice staff would make.

Support staff must not argue, shame, repeatedly press or use fear to obtain agreement. Offer time, written information, a private space, the option of speaking to a registrant, or to decide later where appropriate.

When to pause and escalate

• Clinical refusal: the person refuses a step the optometrist or dispensing optician needs to discuss.
• Pressure from others: a companion appears to force, block or answer for the patient.
• Capacity uncertainty: the person cannot understand, retain, weigh or communicate the decision even with support.
• Safeguarding concern: refusal may be linked to fear, coercion, neglect, exploitation or abuse.
• Immediate danger: urgent risk may require immediate escalation under local procedure.

Manager controls around pressure and vulnerable patients

Voluntary consent means the person is free to choose. Clear information helps; pressure, embarrassment and repeated pushing do not.