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A patient with a history of chronic obstructive pulmonary disease has a living will that states he does not want endotracheal intubation and mechanical ventilation as a means of respiratory resuscitation. As the patients condition deteriorates, the patient asks whether he can change his decision. Which response by the nurse is best?

1) Ill call your physician right away so he can discuss this with you.
2) You have the right to change your decision about treatment at any time.
3) Are you sure you want to change your decision?
4) We must follow whatever is written in your living will.

User Ilya Vo
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Final answer:

The nurse's best response is to affirm the patient's right to change their living will decisions at any time, which respects their autonomy. This should be followed by involving the physician to address any changes formally and ensure that the patient's current wishes are documented.

Step-by-step explanation:

The best response by the nurse to a patient with chronic obstructive pulmonary disease who is contemplating changing their decision regarding endotracheal intubation and mechanical ventilation is: “You have the right to change your decision about treatment at any time.” Patients have autonomy over their medical decisions, and living wills can be updated to match their current wishes. It's crucial to ensure that the patient is making an informed decision and understands the implications of any changes to their advance directives. The nurse may then involve the physician to discuss the details and facilitate any changes to the living will.

In health care, advance directives like a living will or a Do Not Resuscitate (DNR) order reflect a patient's preferences regarding treatments they wish to receive or avoid. These directives can be updated by the patient at any time, emphasizing the dynamic nature of patient consent and ethical practice in medicine. Views on end-of-life care, such as dying with dignity and the use of technology to prolong life, represent significant moral and ethical discussions within the medical field.

User Jason Siffring
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