A practical nurse (PN) is preparing to witness the signature on an informed consent form for a planned biopsy on an older adult client who speaks only Mandarin. The client's adult son, who speaks fluent English, approaches the PN and states, "Please do not tell my father this procedure is to check for cancer. In our culture, discussing a serious illness brings bad energy and destroys hope. I will sign the consent form for him." Which response by the PN is most appropriate?
- I understand you wish to protect him. We must use a professional medical interpreter to ask your father if he prefers to receive his medical information directly or if he designates you to make his decisions.Answer
- BI respect your cultural beliefs, but I must explain the potential complications of the biopsy to your father before I can legally witness his signature.
- CI will inform the healthcare provider of your cultural preferences so the provider can obtain the consent signature from you instead.
- DWhy do you believe discussing the illness will destroy his hope? Being honest with him will likely decrease his anxiety about the procedure.
Answer
The response indicating the use of a professional medical interpreter to ask the client about their preferred decision-making process is the correct choice.
In many traditional cultures, a family-centered approach to healthcare is preferred, and discussing a terminal or serious illness is believed to cause harm. Culturally competent care requires respecting this perspective while maintaining legal and ethical standards. The nurse cannot legally bypass a conscious, competent client's right to informed consent based solely on a family member's request. The most appropriate action is to use a neutral, professional interpreter to directly ask the client how much information they wish to receive and whether they want to designate their son to make medical decisions on their behalf.
Step-by-Step Solution
Key Concept
Balancing Cultural Competence with Legal Informed Consent Requirements