Question

A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. By which of the following is the client's right to self-determination best protected?

1) Respecting the client's desire to have the uncle make choices on her behalf
2) Revisiting the decision when the uncle is not present at the bedside
3) Teaching the client about her right to autonomy
4) Holding a family meeting and encouraging the client to speak on her own behalf

Answer 1

The client's right to self-determination is best protected by respecting her wish to let her uncle make treatment decisions on her behalf, reflecting her autonomy within her cultural context.

Step-by-step explanation:

The client's right to self-determination is best protected by respecting the client’s desire to have the uncle make choices on her behalf (Option 1). While it could be beneficial to ensure the client is aware of her own right to autonomy (Option 3), or to encourage her to speak for herself in a family meeting (Option 4), the ultimate decision rests with the client. If she has explicitly expressed her wish to defer decisions to her uncle, this choice should be respected to adhere to the principle of autonomy in the healthcare setting. The healthcare provider can provide all relevant information to both the client and her uncle so that an informed decision can be made that reflects the client’s wishes.

It's important for healthcare providers to consider cultural considerations in healthcare decision-making. In some cultures, like the one the client may come from, it is a norm for a family patriarch to make decisions. This does not diminish the client’s autonomy but reflects her exercising her autonomy within her cultural context by choosing someone she trusts to make these decisions. Therefore, healthcare providers should respect this method of decision-making, as long as it is informed and voluntary.