An alert and oriented client refuses chemotherapy. The client's family believes that the client should receive it. Which is the nurse's best response to the client?

An alert and oriented client refuses chemotherapy. The client's family believes that the client should receive it. Which is the nurse's best response to the client?

• A. You understand that this decision is ultimately yours to make.
• B. We will respect the family's wishes over yours.
• C. You should do chemo because the family wants it.
• D. We will arrange chemotherapy anyway.

Answer: (A)

Respect for patient autonomy and informed consent. When a competent, alert adult declines a treatment, their decision stands even if family disagrees. The nurse’s best response is to acknowledge that this decision is the patient’s to make, affirm their control, and offer to provide information or facilitate discussion with the family if the patient wishes. This approach protects the patient’s rights, minimizes coercion, and keeps the door open for exploring the patient’s concerns, goals, and understanding of chemotherapy’s risks and benefits. Since the client is alert and oriented, capacity to decide is present, so the nurse should document the refusal, ensure it is informed, and continue to provide support and information about the consequences of refusing treatment. It would be inappropriate to override the decision or pressure the patient or to prioritize family wishes over the patient’s.

Respect for patient autonomy and informed consent. When a competent, alert adult declines a treatment, their decision stands even if family disagrees. The nurse’s best response is to acknowledge that this decision is the patient’s to make, affirm their control, and offer to provide information or facilitate discussion with the family if the patient wishes. This approach protects the patient’s rights, minimizes coercion, and keeps the door open for exploring the patient’s concerns, goals, and understanding of chemotherapy’s risks and benefits. Since the client is alert and oriented, capacity to decide is present, so the nurse should document the refusal, ensure it is informed, and continue to provide support and information about the consequences of refusing treatment. It would be inappropriate to override the decision or pressure the patient or to prioritize family wishes over the patient’s.