A patient refuses a medication prescribed for pain. The nurse recognizes this as a right established by which concept?

• A. The principle of beneficence
• B. The doctrine of negligence
• C. Specific nurse practice acts
• D. The patient self-determination act

Answer: (D)

The main concept is patient autonomy—the right of a capable patient to make decisions about their own care, including the choice to refuse a prescribed medication. The Patient Self-Determination Act supports this by requiring health care facilities to inform patients of their rights to accept or refuse treatment and to document advance directives. When a patient with decision-making capacity refuses pain medication, their wishes should be respected, with appropriate discussion of risks, alternatives, and documentation. If capacity is lacking, decisions should align with the patient’s known preferences or directives.

Beneficence refers to acting in the patient’s best interest but does not override a competent patient’s right to refuse. The doctrine of negligence concerns liability for failure to meet standards of care, not the patient’s right to refuse. Specific nurse practice acts govern nursing licensure and practice, not the fundamental right to refuse treatment, though they include consent considerations.