"This pits sympathy for her plight against medical and medicolegal risks. As such, I would treat it like any risk-vs-benefit situation and write a lengthy note of the likelihood of some risks and the unlikelihood of others, and the complications that can arise from them. This would be an informed consent, like having the patient understand the risks vs benefits of any surgery. I would also document her understanding of it all. Then I would tell her signing out AMA will not negatively upset our patient-doctor relationship and I'd continue to be available for her if she were to need me."

This questions highlights a conflict between compassion and medicolegal risk. You should include in your answer two things: 1. You understand how a patient can get into a jam like this and are sympathetic with her concerns enough to help; and 2. Safety first, for many reasons--medical, ethical, and legal. Both sensibilities are what are being sought from you.

"If it were unsafe to do so, I would not discharge her; however, I would assure her I understand her position and if she were to leave, I would understand and be available to her if she needed me."