A client refuses a procedure that their physician believes is necessary. The nurse's role is to:

Right to refuse treatment:

Legal and ethical foundation: Competent adults have an absolute legal and ethical right to refuse any medical treatment or procedure, including life-saving treatments.

Exceptions: Emergency situations where the patient is unconscious or incapacitated and no advance directive exists; court orders for involuntary treatment (specific narrow circumstances); NURSE'S ROLE: Ensure the client understands the consequences of refusal (informed refusal documentation); assess whether the client is competent to make decisions; notify the RN and physician; document thoroughly (client's statement, understanding of risks, notifications made).

Never: Proceed without consent; coerce; manipulate.

Informed refusal: Must document that: the client was informed of the risks; alternative options were presented; the client's decision was voluntary and free of coercion; a family override is NOT valid — family cannot override a competent adult's decisions.

Advance directives: A living will or healthcare proxy comes into play when the patient is no longer competent — not while the patient can make their own decisions.