When a patient lacks capacity and has a surrogate decision-maker, how should nurses proceed?

• A. Rely solely on physician's decisions.
• B. Ignore surrogate input and wait.
• C. Involve surrogate decisions that reflect patient goals, ensure informed consent, and align with legal policies.
• D. Delegate all decisions to hospital ethics committee.

Answer: (C)

When a patient lacks capacity, nurses work with the legally authorized surrogate to guide care. The surrogate should make decisions that reflect the patient’s known goals and values (or what’s in the patient’s best interests if those goals aren’t known), provide informed consent after clear information about options, risks, and benefits is shared, and follow relevant laws and hospital policies. This approach respects patient autonomy and ensures decisions are ethically and legally appropriate. Relying solely on a physician, ignoring the surrogate, or delegating all decisions to an ethics committee misses the patient’s values and legal rights and is not appropriate for routine decisions.