Pts dictacte their anesthetics all the time and if they say no GA it's not an option w/out looking forward to an assualt charge and loss of licence. It's important to realize that the only absolute contraindication to regional anesthesia is pt refusal. Coags, AS, and all the other stuff is really just degrees or relative contraindications that you have to weigh against the benefits and alternatives. As w/all high risk cases, documentation is key here but I have a feeling you will be on much stronger footing form a medicolegal stand point with proper documentation and a bad outcome doing a regional technique this pt accpets then doing a GA that this pt refuses