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Difficulty: MediumClient Rights and Advocacy

A client with a chronic illness is enrolled in a clinical research trial. During morning medication administration, the client tells the practical nurse (PN), "I do not want to take the experimental medication anymore. It makes me feel nauseous, but the provider told me I have to finish the study." Which of the following is the best action by the PN to advocate for this client's rights?

  1. Inform the client that they have the right to withdraw from the research study at any time without penalty, and notify the provider.Answer
  2. B
    Remind the client that signing the initial informed consent document legally obligates them to complete the study.
  3. C
    Discuss the client's symptoms with other participants in the waiting room to determine if the nausea is a common side effect.
  4. D
    Delegate the task of interviewing the client about their withdrawal concerns to an unlicensed assistive personnel (UAP).

Answer

The practical nurse should support the client's decision, educate them that research participation is entirely voluntary and can be stopped at any time, and escalate the refusal to the prescribing provider.
The Patient's Bill of Rights and ethical guidelines for research dictate that a competent client has the absolute right to refuse treatment or withdraw from a clinical trial at any time, even after initial consent has been given. The practical nurse must advocate for the client's autonomy, protect them from perceived coercion by the provider, and ensure the provider is notified so standard evidence-based care can resume.

Step-by-Step Solution

1
Assess the client's statement regarding their desire to stop the experimental medication.
The client reveals a feeling of coercion from the provider to continue the study despite experiencing adverse effects.
Identifying perceived coercion or a misunderstanding of client rights is the first step in clinical advocacy.
2
Recognize the legal and ethical principles of informed consent.
The PN determines that consent is an ongoing, voluntary process that can be revoked by a competent client at any time.
Client rights dictate that participation in medical research or any treatment plan must remain strictly voluntary.
3
Intervene by educating the client and escalating the refusal.
The PN reassures the client of their right to withdraw without losing standard medical care, withholds the dose, and contacts the provider.
The PN acts as a client advocate to protect the client's autonomy and ensure the healthcare team is aware of the change in the treatment plan.

Key Concept

Informed Consent Revocation and Client Autonomy
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Topics

Client Rights and Advocacy

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