A dying client's family tells the nurse: 'We haven't told Mom she's dying — we don't want to upset her. Please don't tell her either.' How should the nurse respond?

Truth-telling and patient autonomy: Clients have the ethical and legal right to information about their own health condition (autonomy). Withholding information from a competent client at the family's request violates this right and the nurse's ethical duty of veracity (truthfulness).

Cultural context: In some cultures, family rather than patient is the primary recipient of medical information — acknowledge this respectfully while still protecting patient autonomy.

Approach: Acknowledge the family's love and protection motivation (don't dismiss it); explain the ethical obligation; offer a family meeting with social work, chaplain, and/or palliative care to find a culturally sensitive approach; ask the client directly whether they want information about their condition and to what detail — some clients prefer not to know; document the conversation.

What the nurse cannot do: Actively lie to the client about their diagnosis or prognosis; tell the client that everything is fine when it is not.