An client with terminal cancer is dying. For the past several days, th

An client with terminal cancer is dying. For the past several days, the client has refused food and fluids, and pushes the caregiver’s hands away when attempts are made to feed the client or offer any kind of fluid.

The family is considering placing a gastrostomy tube because they feel the client is “starving to death.” The nurse should:
1. Honor the family’s wishes and have them sign a consent form.
2. Talk to the physician so he or she can move forward with the family’s wishes.
3. Honor the client’s refusal and help the family come to terms with the situation.
4. Take the case to the hospital’s ethics committee.

ANSWER

Correct Answer: 3
Rationale 1: Clients, not their families, should make decisions about their own health care and treatment.
Rationale 2: The physician may or may not be involved, but not to disregard the client’s refusal.
Rationale 3: A nurse is morally obligated to withhold food and fluids if it is determined to be more harmful to administer them than to withhold them. The nurse must also honor competent patients’ refusal of food and fluids. This position is supported by the ANA’s Code of Ethics for Nurses, through the nurse’s role as a client advocate and through the moral principle of autonomy. Clients, not their families, should make decisions about their own health care and treatment. In this case, the client has made a decision and it should be honored.
Rationale 4: An ethics committee is usually considered when there is a ethical dilemma and more input is needed to make a decision. In this case, the client has made a decision.