Discussion: “Refuse” or “Decline” – Does the Terminology Matter?

Where people need administration of their medicines, those caring for them ensure that the medicine(s) is administered safely and appropriately by following the six rights of administration.

One of these six rights, the topic for discussion here, is the “right to refuse”.

You may wonder, what is there to discuss?


The answer to that question is very much directed by the culture we are trying to nurture within our care environment.

Person-Centred Care is an oft used phrase. What does it mean to you? As much as it is about what we do and how we do things, it is equally about what we say and how we say things. Our choice of words can give an indication of the efforts we are making to be person-centred.

Despite being relatively interchangeable terms, there are distinctions between the meanings of “refuse” and “decline”.

Which do you think might be a more person-centred term?

Is it something you have ever considered?


Of the two, “refuse” is the stronger word. It often stresses firmness perhaps even rudeness;

“…to refuse to obey an order”

“…to refuse her apology”


However, when someone chooses to “decline”, this often denotes a polite rejection of something. It is commonly applicable to an offer to help or an invitation to a social event;

“…to decline assistance to get down the escalator”

“…to decline a ticket to the football match”

Therefore, whilst “refuse” may be conveyed as being confrontational in nature, "decline" certainly has a softer tone associated with it.

Within a care setting, when somebody chooses not to accept a form of treatment or medicine, do they refuse, or do they decline? Whilst there will be exceptions, likely the person will decline in a polite, courteous manner.

So whilst we are by no means suggesting that there is anything wrong with the use of the word “refuse” instead of “decline” (…we still use it ourselves!!), it’s interesting to open up the discussion to get us thinking about the what and the how.

Do Your Assessors Encourage Discussion?

This kind of open debate and discussion is a key characteristic for anyone who has the role of an assessor within an organisation.

There may be no definite 'right' or 'wrong' on certain matters, but encouraging staff to think about what
they are doing and why their doing it can help them to do what they do better.

Check out our Assessors Workshop today to ensure your managers/ senior staff can properly assess staff, encourage conversations and get the best out of your team.