Final answer:
The nurse should respect the comatose patient's living will which declines enteral nutrition and consult with the hospital ethics committee for guidance, prioritizing patient autonomy and legal directives.
Step-by-step explanation:
When a nurse is caring for a comatose client who has a living will that declines the use of artificial enteral nutrition, and there is a conflict with the family's request for tube feedings, the ethical and legal imperative is to respect the client's wishes as expressed in their living will. Doing so upholds the principle of patient autonomy and aligns with medical ethics and legal precedents surrounding end-of-life decisions. If the nursing staff is confronted with uncertainty or pressure from the family, they should seek guidance by consulting with the hospital ethics committee. This approach follows the established protocol for handling such bioethical dilemmas.
Option 3: Consult with the hospital ethics committee for guidance is often the most appropriate initial action to take when faced with such conflicts. This ensures that the patient's rights are upheld while also considering the concerns and emotional distress of the family. The involvement of the ethics committee provides an opportunity for a fair examination of the situation and helps ensure that the appropriate and legal course of action is followed. In cases where consensus cannot be reached, seeking a court order (Option 4) may become necessary, but this is typically a last resort.