Recently I assessed a patient for wheelchair seating and positioning. I explained to the patient what we were going to do and found another chair that was more suited for him. After he was positioned in the chair, he did not like it. I suggested he give it a day and then make a determination. A day passed, he looked good in the chair, no reddened areas of note and he was sitting up straighter to engage more during lunch and in the hallways. But he still didn't like the chair and requested to have the old chair back. I relented, figuring he had a right to have the old chair and maybe he would notice the difference between the two. He didn't.
Then I found an even better chair that maneuvered easier to propel down the hall. He still didn't like it even though it provided a better fit and he could get around easier. I go back and forth with this type of thing. His old chair was too small and had the potential to create skin breakdown. The wheels were difficult to roll and the seat was like a hammock. But still he wanted it.
Should we, after careful review with patients, allow them to create more harm than good to themselves? What if he wanted to cut himself or refused bathing? When do we intervene for the betterment of patients despite their rights?