What must a nurse ensure before performing a procedure on a competent adult who declines consent?

• A. Respect autonomy; do not perform the procedure; document the refusal and discuss alternatives.
• B. Proceed if there is urgency
• C. Obtain consent from a family member instead
• D. Ignore the decline if the patient seems upset

Answer: (A)

Respecting autonomy means recognizing that a competent adult has the right to accept or refuse any medical treatment. Before performing a procedure, the patient must give voluntary, informed consent. If they decline, the nurse must not proceed, even if there seems to be benefit. The nurse should verify that the patient understands the procedure, its risks and benefits, and any alternatives, and ensure there’s no coercion. Document the refusal thoroughly in the medical record and discuss acceptable alternatives or supportive options that align with the patient’s values and goals. Continue to provide care and information as needed, and revisit consent later if appropriate. Even if the patient is upset, their decision must be respected, with efforts focused on addressing concerns and ensuring clear understanding.