[Direct answer]In the Beijing area, if a patient dies after signing a consent form refusing treatment, the hospital is not necessarily exempt from liability. According to Article 1224 of the Civil Code of the People's Republic of China, if a patient or their next of kin do not cooperate with treatment that meets medical standards, the medical institution does not bear compensation liability, but if the medical staff are at fault, they should still bear corresponding compensation liability. In practice, courts usually determine the degree of fault based on appraisal opinions and apportion responsibility proportionally. It is common for families to waive treatment to reduce rather than exempt the hospital's liability. It is recommended to immediately seal and copy the medical records, apply for a cause of death appraisal as soon as possible after the patient's death, and apply for a medical damage appraisal if necessary, then claim compensation based on this. For related disputes, please refer to the relevant provisions.Personal injury and medical dispute services.

1. Problem background and typical scenarios

When the patient's condition deteriorates severely or after surgery, the family signs the discharge papers despite being repeatedly informed by doctors that the patient's condition is critical and requires continued hospital treatment. The patient dies either at home or during transfer, and subsequently, the family and the hospital dispute over the responsibility. This is a relatively typical type of medical dispute. Common scenarios include: the family signing the papers to abandon treatment due to financial burden, care difficulties, or loss of confidence in the treatment effect; the hospital failing to make every effort to save the patient after being informed or failing to fully explain the risks of referral; and the patient explicitly refusing certain treatments when they are conscious. The disputed points in such cases do not lie in whether the hospital is necessarily exempt from liability after signing the papers, but in the causal relationship between the signing behavior and the death outcome, as well as whether the hospital's own medical treatment behaviors have any faults. When it comes to the enforcement of compensation payments, it can be combined with the following factors:Special services and other case servicesPlanning.

II. Key points of contention

The dispute mainly revolves around three points. Firstly, the legal effect of signing documents: informed consent forms or statements of refusal to receive treatment can prove that the medical institution has fulfilled its obligation to provide information, and may constitute evidence of the patient's lack of cooperation with the treatment, but it does not necessarily exempt the hospital from liability for fault. Secondly, the relationship between fault and causality: it is necessary to determine through medical damage appraisal whether the hospital has fulfilled its medical obligations corresponding to the current medical level in the diagnosis, treatment, referral, and information disclosure processes, and the extent of the fault's causality to the death outcome. Thirdly, the division of liability proportion: the court usually refers to the degree of fault participation in the appraisal opinion to determine the proportion of liability borne by the hospital, and the remaining part is borne by the patient. Similar disputes can be referred to for reference.Personal injury and medical dispute services.

III. Professional analysis by Henglue Lawyers

Based on practical observations in handling medical malpractice cases, the success or failure of such disputes highly depends on medical records and expert appraisals. Hospitals often retain more complete materials during the informed consent process, and patients without professional preparation are easily put on the defensive in terms of evidence collection. Therefore, Henglue Lawyers usually recommend the following: Apply for the seal-up of all medical records and copy the objective medical records as soon as possible; if there are objections to the cause of death, apply for an autopsy within 48 hours after the patient's death in accordance with the provisions of the "Regulations on the Prevention and Handling of Medical Disputes" (effective from October 1, 2018). If the body is preserved by freezing, the deadline can be extended to seven days. Any delay will affect the determination of the cause of death; apply for a medical malpractice appraisal after suing, and put forward clear appraisal items concerning medical treatment errors, causality, and involvement. If the hospital forges, alters, or conceals medical records, it can be presumed to be at fault. After the judgment, the enforcement of the compensation can be connected to the next step.Creditor-debtor relations and enforcement case services.

IV. Practical suggestions and legal basis

The legal basis mainly includes Article 121 of Chapter VI of the Civil Code of the People's Republic of China (adopted on May 28, 2020 and implemented on January 1, 2021): Liability for Medical Damage; Article 122 (Liability for Fault of Medical Institutions or Their Medical Staff); Article 123 (Duty of Explanation and Express Consent); Article 124 (Liability for Failure to Fulfill Corresponding Diagnosis and Treatment Obligations); Article 125 (Presumption of Fault for Violating Diagnosis and Treatment Standards, Concealing or Refusing to Provide Medical Records, or Forging, Altering, or Destroying Medical Records); Article 126 (Exemption from Liability and Liability Sharing for Patients or Their Near Relatives Who Do Not Cooperate with Diagnosis and Treatment); and the supporting regulations, the "Regulations on Prevention and Handling of Medical Disputes" (implemented on October 1, 2018). Practical suggestions include: promptly sealing and copying medical records and applying for an autopsy; truthfully stating the reasons and process of giving up treatment; clarifying the fault and degree of participation through appraisal, and negotiating or suing for medical expenses, death compensation, funeral expenses, and compensation for mental distress based on the appraisal conclusion. For the distribution of death compensation among near relatives, reference can be made to the relevant provisions of the "Regulations on the Administration of Compensation for Death of Citizens". 法律依据主要为《中华人民共和国民法典》（2020年5月28日通过，2021年1月1日施行）第七编第六章医疗损害责任：第一千二百一十八条（医疗机构或其医务人员有过错的责任）、第一千二百一十九条（说明义务与明确同意）、第一千二百二十一条（未尽相应诊疗义务的责任）、第一千二百二十二条（违反诊疗规范、隐匿或拒绝提供病历、伪造篡改销毁病历的推定过错）、第一千二百二十四条（患者或近亲属不配合诊疗的免责与责任分担）；配套法规为《医疗纠纷预防和处理条例》（2018年10月1日施行）。实务建议：及时封存、复印病历并申请尸检；如实陈述放弃治疗的原因与经过；通过鉴定明确过错与参与度，据鉴定结论协商或起诉主张医疗费、死亡赔偿金、丧葬费与精神损害抚慰金。死亡赔偿金在近亲属间的分配，可参考《民法典》相关规定。Inheritance succession and family property division services.

5. Henglu Law Firm's Advice

There are three points to note: Firstly, signing a document refusing or waiving treatment does not exempt the hospital from liability entirely. If the hospital itself is at fault, such as misdiagnosis, delayed treatment, or failure to fully inform about the risks of referral, it may still be required to bear a corresponding proportion of compensation liability. Secondly, autopsies and the sealing of medical records have a very strict time limit. Once the deadline has passed, it will be difficult to determine the cause of death and the facts of the treatment, which often directly affects the outcome of the case. Thirdly, when negotiating with the hospital, don't be in a hurry to sign a one-time settlement agreement. You should first obtain the medical records and appraisal opinions and listen to professional advice before making a decision. If you need to evaluate a specific case, you can visitHomepage of Beijing Henglue Law FirmUnderstand the consulting process.

VI. Frequently Asked Questions

Q1: If the family member has signed a consent form refusing treatment, can they still sue the hospital?

It is possible to sue, but whether the hospital is liable depends on whether it has any fault of its own. According to Article 1224 of the Civil Code, if the patient or his/her near relatives do not cooperate with the medical institution in conducting medical treatment in accordance with the clinical treatment norms, the medical institution shall not bear liability for compensation; but the article also stipulates that if the medical institution or its medical staff also have faults, they shall still bear corresponding liability. Therefore, signing the consent form is just one of the influencing factors. If the hospital has situations such as misdiagnosis, missed diagnosis, delayed rescue, failure to fully inform the patient of the risks of referral, or violation of clinical treatment norms, it may still be ordered to bear a certain proportion of compensation. The court usually determines the degree of fault participation and allocates responsibility based on the appraisal opinion.

Q2: What key evidence is needed for such cases?

The core elements are medical records and appraisal materials, including copies of objective medical records such as hospitalization records, nursing records, medical orders, and examination reports, as well as sealed records; the original and signed materials of the statement of refusal or abandonment of treatment; death certificates and autopsy reports; transfer and emergency records; audio recordings of communication with medical staff and WeChat records; and bills for medical expenses and funeral expenses. If the hospital refuses to seal or provide medical records, the patient should apply in writing and keep the evidence in order to claim presumed fault. The goal of organizing evidence is to prove that the hospital committed medical malpractice and that there is a causal relationship between the malpractice and the death outcome.

Q3: How much does it cost to litigate such cases?

The main expenses include case acceptance fees, appraisal fees, and attorney's fees. According to Article 13 of the "Measures for the Payment of Litigation Costs" (State Council Decree No. 481, implemented on April 1, 2007), the case acceptance fees are paid in stages based on the amount of the compensation requested, with the fee rate decreasing as the amount increases. Ultimately, the losing party bears the fees or shares them according to the outcome of the case; the medical damage appraisal fees are usually paid in advance by the applicant; and the attorney's fees are determined through negotiation between the client and the law firm. Medical cases are highly specialized, so it is recommended to first assess the possibility of hospital negligence before conducting an appraisal to avoid investing in appraisal fees only to still end up with unfavorable conclusions.

Q4: How long does it usually take from filing a lawsuit to receiving compensation?

The litigation period for medical malpractice cases is usually longer than that for ordinary civil cases. Cases applying the summary procedure are generally concluded within three months after the case is registered, and those applying the ordinary procedure within six months. However, medical malpractice appraisals often take several months, and after the appraisal opinion is issued, there may be supplementary appraisals or reappraisals. The overall litigation period is typically around one year. If one party appeals, the second-instance trial will also take several months; if the other party fails to perform after the judgment becomes effective, an application for enforcement must be made. According to the "Regulations on the Prevention and Handling of Medical Disputes", autopsies for disputes over the cause of death should be conducted within 48 hours after the patient's death, and those with freezing storage conditions can be extended to seven days.

Q5: What should family members do now?

It is recommended to handle the matter in five steps: 1. Immediately submit a written request for the sealing and copying of all medical records, including objective and subjective medical records. 2. If there are objections to the cause of death, apply for an autopsy within 48 hours after the patient's death. If conditions permit, the deadline can be extended to seven days. 3. Retain the death certificate, transfer records, communication recordings, and all expense receipts to avoid conflicts with the hospital or signing a one-time settlement agreement hastily. 4. Entrust a professional lawyer to assess whether the hospital is at fault and, if necessary, file a lawsuit and apply for a medical injury appraisal. 5. Based on the degree of fault determined by the appraisal, claim medical expenses, death compensation, funeral expenses, and compensation for mental distress. Throughout the entire process, attention should be paid to the timeliness of actions and the completeness of evidence.

This article is written based on the common judicial interpretations in the Beijing area. If the case occurs in other regions, it is recommended to consult local lawyers to verify the regional differences.

VII. Related public cases (for reference only, not handled by our firm)

The following cases are all sourced from the official websites of courts at all levels, judicial authorities, and authoritative media, and have been publicly disclosed. They are unrelated to the cases handled by our firm. They are provided solely for reference in understanding relevant adjudication rules and do not constitute opinions on specific cases.

[Case No.]The case number has not been made public.
[Trial Court]The People's Court of Xuyi County, Jiangsu Province (case of liability dispute for medical damage to a newborn, first-instance judgment effective)
[Judicial Summary]Hu * gave birth to a live baby girl at a hospital in Xuyi County. After delivery, the baby was diagnosed with severe asphyxia and was transferred to a maternity and child health care hospital for treatment on the same day. Despite being repeatedly informed by the maternity and child health care hospital that the child's condition was critical and required continued hospitalization, Hu *, as the legal guardian, still insisted on discharging the child. During the discharge process, the child suffered from cardiopulmonary arrest and died despite resuscitation efforts. According to the appraisal, there were errors such as untimely and improper treatment during the diagnosis and treatment process at the hospital in Xuyi County. The court held that the family signed the discharge request despite being clearly informed by the medical institution of the child's condition and the need for continued hospitalization, which constituted a situation of "close relatives not cooperating with the medical institution in carrying out treatment in accordance with medical treatment norms". However, if the medical institution and its medical staff also have faults, they should bear corresponding compensation responsibilities. The court determined that the hospital should bear 20% of the compensation responsibility, and the remaining 80% should be borne by the plaintiff herself.
[Source]The official website of the court system in Jiangsu Province (Xuyi County People's Court: If the patient dies after the family members give up treatment, the hospital's liability for compensation for medical malpractice should be reduced) (2025-02)

[Case No.]The case number has not been made public.
[Trial Court]Yunnan Daiyao County People's Court (Medical Damage Liability Dispute Case)
[Judicial Summary]The patient was hospitalized for treatment due to chest pain. The pathological report after appendectomy showed acute simple appendicitis. The next day after the surgery, the patient suddenly lost consciousness. After one hour and 50 minutes of rescue efforts, the patient's pupils dilated and fixed, and the great artery pulse could not be detected. The family requested to give up rescue and discharge the patient, and the patient died after returning home. The appraisal opinion concluded that the hospital's medical treatment actions were at fault and had a partial causal relationship with the harm consequences, recommending a fault participation rate of 20% to 40%. The court held that although the patient's death was related to the family's decision to give up treatment, the hospital's medical treatment actions were also a contributing factor to the death outcome. The court confirmed that the hospital should bear 40% of the fault responsibility for the death outcome and accordingly assume 40% of the compensation liability, compensating the family of the deceased 326,049.66 yuan.
[Source]The official website of the Yunnan Provincial Court System (Daiyao County People's Court: The patient died the day after the appendicitis surgery, and the court made this judgment) (2020-10)

If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the evidence materials, to avoid missing the statutory time limit. →Personal injury legal services·Beijing Henglu Law Firm

Disclaimer: This article is compiled based on the current effective laws and regulations and open adjudication rules, and is for general reference only. It does not constitute a formal legal opinion on specific cases. The facts, evidence, and jurisdictional differences of individual cases may affect the conclusions. If you encounter disputes, please consult a practicing lawyer in time.