A client has chosen to discontinue hemodialysis, but the client's family is not supportive of the decision. The nurse who uses the theory of principles-based reasoning would make which statement?

Question

1. "This client is of sound mind and is capable of making independent decisions regarding health care. It really is the client's decision to make.".
2. "I need to try and help the family understand the client's decision so they can work through this situation together.".
3. "This client's health is so deteriorated that the treatment is not saving the client's life. It is prolonging the ultimate outcome, which is death.".
4. "The client understands the decision and the advanced stage of the disease. If the client quits treatment, the client will die.".

Answer 1

1. "This client is of sound mind and is capable of making independent decisions regarding health care. It really is the client's decision to make.".

Rationale:
Principles-based theories stress individual rights, like autonomy. The client has the ability to make the decision, and it is his right to autonomy to do that. Trying to help the family understand the client's decision is an example of a caring-based theory in practice. Caring theories, or relationship theories, stress courage, generosity, commitment, and the need to nurture and maintain relationships. Caring theories promote the common good or the welfare of the group. Considering the client's condition and the outcome of treatment is an example of consequence-based reasoning, in which the nurse looks at the outcomes of the client's decision. The client's understanding of his decision and its consequences does not address the client's right to make a decision autonomously.