A client with terminal colon cancer is refusing all food and fluids. The client has a living will that states no artificial nutrition is to be provided; however, the family is asking for a gastrostomy tube. What should the nurse do?
A) Take the case to the hospital's ethics committee.
B) Talk to the physician so he or she can move forward with the family's wishes.
C) Honor the client's refusal and help the family come to terms with the situation.
D) Honor the family's wishes and have them sign a consent form.
Answer: C
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 clients' 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. The physician may or may not be involved, but would not disregard the client's refusal. An ethics committee is usually considered when there is an ethical dilemma and more input is needed to make a decision. In this case, the client has made a decision and it should be honored.
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