What If My Patient Refuses to Wear a Mask?


The Texas Medical Board’s (TMB) emergency rule establishing minimum safe-practice standards related to COVID-19, and its frequently asked questions (FAQ) document on the rule, continue to generate a lot of questions from physicians.

Specifically, the provision requiring physicians, their delegates, and patients to wear masks when a physician or delegate is less than 6 feet from the patient has resulted in a lot of calls to the Texas Medical Association Knowledge Center.

TMA’s Office of the General Counsel (OGC) is working on its own FAQ to help answer those questions. Look for it in the coming days.

In the meantime, below is a preview of the TMA OGC’s FAQ on one exception to the mask or face covering requirement to help you better understand how to stay in compliance while also keeping yourself, your staff, and your patients safe.

What if the patient refuses to wear a face covering and no exception applies?

TMB does not require a physician to treat a patient who is physically and mentally capable of wearing a mask or face covering, but refuses to do so. However, there may be other duties that apply in certain circumstances, such as for a patient with an urgent or emergent condition. For example, the American Medical Association (AMA) Ethics Opinion No. 1.1.7 requires a physician to provide care in emergency situations. There is also a duty in certain circumstances to provide emergency care under the federal Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd). AMA Ethics Opinion No. 8.3 discusses specific obligations a physician has during a disaster or pandemic to provide urgent medical care. Also please note that the AMA Ethics Opinion No. 1.1.2 prohibits a physician from rejecting a patient solely on the basis of the individual’s infectious disease status.

There are other exceptions to the rule that may also apply. More on those exceptions and other information pertaining to the rule will be included in the forthcoming TMA FAQ.

To help answer questions and address concerns you might have about Texas’ supply of personal protective equipment (PPE), the TMA COVID-19 Task Force has also created an FAQ that addresses topics such as conservation strategies; options if N95 masks are unavailable; whether you should use homemade masks; and whether surgical masks, gloves, and gowns should be reused or used for more than one procedure.

You also can find the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.

As always, this article is not a substitute for the advice of an attorney. For specific legal advice on a physician’s duty to provide urgent or emergent care, please contact your retained counsel. Certain links provided with this information connect to websites maintained by third parties. TMA has no control over these websites or the information, goods, or services provided by third parties. TMA shall have no liability for any use or reliance by a user on these third-party websites.

Last Updated On

May 13, 2020

Originally Published On

May 13, 2020

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