In a scenario where prognosis uncertainty exists and family pressures decisions, how should the nurse respond?

• A. Yield to family pressure regardless of patient wishes.
• B. Make decisions without patient or family input.
• C. Prioritize patient autonomy, seek consent, involve ethics as needed.
• D. Delay conversation indefinitely.

Answer: (C)

Respecting the patient’s autonomy is the guiding principle, even when prognosis is uncertain and family pressures arise. Begin by assessing the patient’s capacity to participate in decisions and, if they are competent, provide clear, honest information about prognosis and uncertainties, then invite the patient to express their goals and values and obtain informed consent for the chosen plan. If conflicts with family occur, facilitate dialogue that keeps the patient’s preferences at the center and involve ethics resources as needed to support decisions that reflect the patient’s wishes. If the patient cannot participate, identify the surrogate decision maker based on known values or advance directives and ensure that any choices align with what the patient would have wanted. Delaying conversations or making decisions without patient or family input undermines trust and autonomy, so ongoing, transparent communication is essential.