An alert and oriented older adult client is diagnosed with a severe, life-threatening infection in the lower extremity. The healthcare provider recommends an urgent surgical amputation. After the provider leaves the room, the client calmly tells the nurse, 'I have lived a long, full life. I do not want to have my leg cut off, even if it means I will die from this infection.' What is the most ethically appropriate action by the nurse?
- Acknowledge the client's decision, document the refusal, and notify the healthcare provider.Cevap
- BTell the client that refusing the surgery is a poor choice and repeatedly emphasize the benefits of the procedure.
- CAssume the refusal stems from age-related cognitive decline and contact the family to obtain surrogate consent.
- DDirect an unlicensed assistive personnel (UAP) to remain with the client and provide education about the surgical risks.
Cevap
The most ethical action is to acknowledge the client's decision, document the refusal, and notify the healthcare provider.
The ethical principle of autonomy gives competent adult clients the right to make their own healthcare decisions, including the right to refuse life-saving treatment. Because the client is alert and oriented, the nurse must respect their self-determination, advocate for their wishes, document the refusal thoroughly, and inform the healthcare provider so the overall plan of care can be updated.
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Anahtar Kavram
Client Autonomy and the Right to Refuse Treatment