Oh, come on - be fair! You allowed him to make an informed decision, albeit in something of a forceful manner. I agree that one should be frank from the outset, hopefully negating the need to scare the shit out of a patient when they don't do what you want. I'm sure you tried your best - I personally really hate the way we, as health professionals, are supposed to pussy-foot around and not tell people about the scary stuff (like never being allowed to say "cancer" to a patient until you've got a tissue diagnosis, even when you're 95% sure and they just want to know what you're investigating for and already think they've got cancer). That's not a pop at you - I agree about all the hippy stuff. I think showing respect should mean being honest. Patients tend to get a lot more scared if they sense you're tiptoeing round something. If, armed with the information you gave him, he had still refused, and was competent to make the decision, you would have had no choice but to leave him. You wouldn't have been able to say "either you come with me or I call the coppers." It just so happens that when there's some kind of psychiatric-type behaviour, you can pull the legal trump card to get them to do what you want, which, as you know, is something I raised issue with.