b. The nurse must ascertain the status of a health care proxy and other mandates by the patients request such as DNR (Do Not Resuscitate) orders, etc.
c. The mental stability of the patient may need to be reviewed to ascertain whether such decision by the patient can be made according to hospital policy, state and federal laws.
Interpretation:
4: The issue of informed consent and/or refusal has several dimensions when dealing with any population, including HIV. The first, and probably the most important, is the attempt to ascertain the cognitive capacity of the patient in determining his or her own care and treatment. Any adult whose decision-making capacity is intact has the right to absolute self-determination in making informed health care decisions. "A person with HIV has the right to refuse any medical treatment or procedure, even if a decision not to undergo treatment may result in death." (Rubenstein, Eisenberg & Gostin, 1996, p. 110)
4a: These decisions are part of the care of the patient and should be thoroughly scrutinizes and not left one person's sole responsibility.
4b: Living Wills, health care proxy, DNR orders, etc. should certainly all be in place in order to assure that the patient's rights and wished are followed if he or she is incapacitate.
4c: However, though it may be established that the patient does not have the capacity to make the decision a court may intervene:
Most courts have recognized that patients who lack capacity to make decisions still have some sort of interest in refusing treatment. These rights are founded in the state or federal rights to privacy or liberty, the doctrine of informed consent, or both…[the] courts have...
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