What is a physician's legal and ethical responsibility to a patient who signs out against advice?

Does a physician have a legal and ethical responsibility to a patient who signs out against medical advice if that patients decision to do so is prompted by the belief that the physician is not adequately meeting their medical needs?

If a physician refuses to provide prescriptions to a patient whom he or she knows needs them to get better and knows the patient will be compliant with those medications, does the physician cross a legal or ethical line in refusing to write those prescriptions for the patient.

Keep in mind that the patient in this case signed out against medical advice after the physician refused to listen to the patient, was rude, inconsiderate, showed little compassion, and was more worried about being "right" than treating the patients illness. Also, the patient in this case is in medicine and knows what the standards are.
This would be applicable to the State of New Hampshire guidelines only. Thanks in advance for your help!

It does not matter WHY a patient signs out AMA. Once the AMA is signed, the physician and hospital are released from liability of that patient. If the patient is unhappy with the medical care he/she receives, this is a free country and they are free to find themselves another physician or go to another hospital. Bottom line: the patient signed out AMA, he/she has no legal recourse against the physician or hospital. The hospital/physician is not responsible for the transport of that patient home, and is not to provide prescriptions or medical care past that point. The patient is also financially liable for his/her care up to the point of leaving and most insurances will not cover the hospitalization if the patient leaves against medical advice. Now why do patients decide to leave AMA? Well 95% of the time it is because "their needs aren't being met", "the physicians and staff are being rude and incompassionate" example: patient with "chronic pain" who exhibits drug-seeking/addictive behavior leaves AMA because the physicians will not give him/her the amount medication that they believe is adequate. Believe me, patients don't leave AMA because "they decide they just don't need to be in the hospital" Physicians are not always right but you cannot discount the amount of training they have to go through to be able to practice. But then again since your friend is "in the medical field" and knows the "standard of practice" he/she should already know this.

I believe that a physician can refuse med's to a patient, he can't refuse treatment. If this "patient" signed out on his/her own free will.....then so be it, it was against the physician advice. Remember, med's are not necessarily treatment, only covers up the symptoms of an illness.......not always, but sometimes. Remember this was against his wishes. He did his job, tell this patient to quit whining and if he or she believes they were not getting adequate treatment, then they should get second opinion and find another physician. Doctors can appear to have a rude and non-caring approach, this is only a personality clash between the two, its time to seek different medical advice. I believe that by signing out, the patient absolved the doctor of an further responsibility

It doesn't matter whether you are in Vermont or anywhere. Once you sign that you are leaving AMA and the physician has explained that is not in your best interest then he has no more responsibility to you. This also applies to Paramedics, Nurses, and any other health care provider. Once you sign AMA you have just given them a get out of jail free card for any lawsuit you might try to bring. It doesn't matter how rude or overbearing the person has been. Your only "out" in this situation is if you can prove, and I mean really prove, that you were not of sound mind when you signed the AMA form.

THIS IS ONLY MY OPINION. If you and your physician do not see eye to eye and you truly believe that said physician is "not adequately meeting their medical needs" it is the patients' responsibility to seek a different practitioner.
Upon signing out AMA you have severed any fiduciary responsibility that the physician may have had with regard to your care. Good luck with your treatment and in finding a competent physician who wants to help and listen to you and isn't rude.