A client has chosen to discontinue hemodialysis. His family is not supportive of his decision. Which statement should the nurse make that demonstrates the theory of principles-based reasoning?

Question

1. "This client is of sound mind and is capable of making his own decisions regarding health care. It really is his 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 his life. It is prolonging the ultimate outcome, which is his death."
4. "The client understands his decision and the advanced stage of his disease. If he quits treatment, he will die."

Answer 1

Correct Answer: 1
Rationale 1: Principles-based theories stress individual rights, such as autonomy. The client has the ability to make the decision and it is his right to autonomy to do that.
Rationale 2: 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. Trying to help the family understand the client's decision is an example of a caring-based theory in practice.
Rationale 3: Consequence-based theories look at the outcomes of an action in judging whether that action is right or wrong.
Rationale 4: Consequence theories are exemplified by the nurse looking at the outcomes of the client's decision.