Final answer:
Nurses may not inform clients declared incapable about a substitute decision-maker in situations like the existence of an advanced directive or DNR order, urgent medical emergencies, or if the client is mentally incompetent and providing such information would cause undue distress.
Step-by-step explanation:
In certain circumstances, it may not be reasonable or possible for a nurse to inform a client (found incapable) that a substitute decision-maker will be asked to make decisions on his or her behalf. Such situations include cases where the individual has an advanced directive or a living will that already specifies their wishes for medical treatment, which may also include a Do Not Resuscitate (DNR) order. Moreover if a patient has already appointed a health care proxy, the need to inform them becomes redundant as the proxy is empowered to make decisions. additionally in an urgent or emergency situation where immediate medical decisions are required and the patient is incapacitated without any clear advanced directives, the healthcare professionals may need to act in the best interest of the patient without delay.
It is also notable that in situations where the client is not mentally competent to understand the information due to conditions like severe dementia or in cases where providing such information would cause extreme distress that outweighs the benefits of informing them, the nurse may be justified in refraining from discussing the role of a substitute decision-maker. For example a senile bishop who is unable to comprehend his condition may not be informed about the involvement of a substitute decision-maker if it does not beneficially impact his care or well-being.