A registered nurse in the United States is caring for a patient who lacks decision-making capacity and has no advance directive. The patient's adult children disagree about a nonemergency treatment. What should the nurse do first?
Correct answer: B. Identify the legally authorized decision maker
- A. Ask the nurse to choose the treatment
- B. Identify the legally authorized decision maker
- C. Allow the loudest family member to decide
- D. Proceed without consent because the patient lacks capacity
Explanation
The team must identify the legally authorized surrogate under applicable law and facility policy before proceeding with nonemergency treatment. Family disagreement may require the provider, social worker, or ethics service to clarify authority and resolve the conflict.
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About US Legal and Ethical Nursing Practice
US nursing law and ethics include state nurse practice acts, scope of practice, standards of care, negligence, malpractice, documentation, confidentiality under HIPAA and informed consent. Ethical reasoning applies autonomy, beneficence, nonmaleficence, justice and fidelity to conflicts such as refusal of treatment, advance directives, privacy breaches and mandatory reporting, which are not the same as legal liability.
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