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Question

Difficulty: EasyEthical Practice

A nurse is caring for an oriented adult client who was recently diagnosed with a terminal illness. The client states, "I do not want any further treatments; I just want to be kept comfortable." The client's adult child privately approaches the nurse and says, "You must give my parent the treatments anyway. They do not know what they are saying." Which action by the nurse best demonstrates adherence to the ethical principle of autonomy?

  1. Validating the client's decision to decline treatment and facilitating a transition to comfort-focused careAnswer
  2. B
    Proceeding with the prescribed life-prolonging therapies because preserving physiological stability is the highest priority
  3. C
    Asking the client, "Why do you want to stop treatment when there is still a chance it might help?"
  4. D
    Reporting the adult child to the authorities immediately for suspected emotional abuse and neglect of a vulnerable adult

Answer

Validating the client's decision to decline treatment and facilitating a transition to comfort-focused care
The ethical principle of autonomy guarantees a competent client the right to make their own healthcare decisions, including the absolute right to refuse life-prolonging treatments. By validating the client's wishes and shifting the focus to comfort care, the nurse actively advocates for and respects the client's self-determination, even when family members disagree or are distressed.

Step-by-Step Solution

1
Evaluate the client's competency and stated wishes regarding their care.
The client is described as oriented and has clearly expressed a desire for comfort measures only.
Mentally competent adults have the legal and ethical right to refuse medical interventions.
2
Identify the ethical principle at stake in the scenario.
The primary principle is autonomy, which is the client's right to self-determination.
The family member's demand to continue treatment directly conflicts with the client's expressed autonomous decision.
3
Determine the nursing action that correctly upholds the client's autonomy.
The nurse must advocate for the client by validating their decision and focusing on the requested comfort care.
A nurse's primary ethical obligation is to the client and their right to make independent healthcare choices, not to the preferences of family members.

Key Concept

Client Autonomy in Healthcare Decision-Making
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Topics

Ethical Practice

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