A client with advanced amyotrophic lateral sclerosis has decision-making capacity and has named an adult son as health care agent in a durable power of attorney for health care. The client declines placement of a gastrostomy tube. The son tells the nurse, "I'm the health care agent, so the tube is going in." Which response by the nurse is most appropriate?
- A"As the health care agent, you have the legal authority to make this decision for your parent."
- B"Your parent's refusal needs to be written in an advance directive before it can be honored."
- C"Because you and your parent disagree, the ethics committee will make the final decision."
- D"Your parent can still make this decision, so the refusal will be respected."
Show answer and explanations
Answer
D
A: An agent does not override a client who currently has decision-making capacity. B: A capable client's informed verbal refusal is valid; it does not need to be written in an advance directive to be honored. C: An ethics consultation supports deliberation but does not automatically replace the client's decision. D: While the client retains capacity, the client's own informed refusal guides care; the agent's authority applies only when capacity is lost.
A
An agent does not override a client who currently has decision-making capacity.
B
A capable client's informed verbal refusal is valid; it does not need to be written in an advance directive to be honored.
C
An ethics consultation supports deliberation but does not automatically replace the client's decision.
D
While the client retains capacity, the client's own informed refusal guides care; the agent's authority applies only when capacity is lost.