In ethical end-of-life care, which statement best reflects respecting a competent patient's autonomy when refusing treatment?

• A. Family preferences override the patient’s wishes.
• B. Physicians decide what is best for the patient.
• C. A competent patient has the right to refuse treatment.
• D. The patient must continue treatment if it’s beneficial.

Answer: (C)

Respecting a competent patient's autonomy means recognizing their right to make and refuse choices about their own care based on a clear understanding of the situation. If a patient is judged to have decision-making capacity, their informed decision to decline treatment should be honored, even if others think continuing treatment is beneficial. This upholds the fundamental idea that individuals control what happens to their bodies and lives when they are capable of deciding.

In practice, you ensure capacity is present, provide thorough information about options, risks, and outcomes, and check that the patient truly understands and is freely choosing. If the patient refuses, you support that choice, discuss alternatives for comfort and symptom relief, and document the decision. If the patient lacks capacity, decisions should be guided by advance directives or a legally authorized surrogate, not by overriding the patient’s previously stated wishes.

The other ideas don’t fit with respecting autonomy: letting family preferences override the patient’s wishes substitutes someone else’s values for the patient’s, physicians deciding for the patient removes the person from the decision-making loop entirely, and insisting the patient must continue if a treatment seems beneficial ignores the patient’s right to decline even when care might be advantageous.