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"Discuss the primary ethical considerations a nurse must navigate when providing care to a patient who refuses a life-sustaining treatment, and how these considerations might influence the nurse's actions. (5 marks)"
A nurse caring for a patient refusing life-sustaining treatment faces a complex ethical dilemma, primarily balancing:
* Patient Autonomy: Respecting the patient's right to make informed decisions about their own body and care, even if those decisions seem to conflict with the nurse's professional judgment or the goal of preserving life. This is paramount.
* Beneficence/Non-maleficence: The nurse's duty to act in the patient's best interest (beneficence) and to do no harm (non-maleficence). This can be challenged when a patient's autonomous decision might lead to a negative health outcome or death.
* Veracity and Fidelity: Ensuring the patient has all necessary information to make an informed decision (veracity) and maintaining trust and loyalty to the patient (fidelity), even when their choices are difficult.
These considerations influence the nurse's actions by:
* Facilitating informed decision-making: Ensuring the patient understands their condition, prognosis, and consequences of refusal.
* Advocacy: Advocating for the patient's wishes while also ensuring comfort and dignity.
* Emotional support: Providing emotional support to the patient and their family.
* Documentation: Meticulously documenting all discussions and the patient's decision.
* Collaboration: Consulting with the healthcare team, ethics committee, and legal counsel if necessary.
* Self-reflection: Grappling with personal values and potential moral distress.
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