Early in my dialysis I had a day when extreme cramp made me ask to come off early. I was given an "against medical advice" form to sign, and did so without complaint. A few weeks later, for reasons that were the clinic's fault, we started late and they wanted me to finish early. I said that this was OK with me, but I would need the nurse to write out a note saying this was her decision and that she took full legal responsibility for any harm it caused me. She (understandably) argued and I pointed out that this was exactly the same as when I signed an "against medical advice" form, so it was only reasonable for me to expect it. The result was that I got the full dialysis time.