Refusal of treatment by the patient must always be documented. Otherwise, the doctor may be held guilty of negligence for not carrying out a surgery or other such treatment/intervention in an emergency because of non-availability of consent (Indian J Anaesth. 2015 Nov;59(11):695-700). 

In Dr. T.T. Thomas vs Smt. Elisa And Ors. on 11 August, 1986, I (1987) ACC 445, AIR 1987 Ker 52, the Kerala High Court held as follows: “… we hold that the burden of proof to show want of consent from the deceased is on the appellant, and he failed to discharge that burden. We also hold that the failure to perform an emergency operation on the deceased … amounts to negligence, and the death of the deceased was on account of that failure. For the aforesaid reasons, we find that the court below was perfectly right in fastening the appellant with the liability for the death of the deceased.”