When may treatments be withheld or withdrawn in a deteriorating patient?

• A. Always without discussion.
• B. Based on patient preferences, advance directives, or best interests.
• C. Based on clinician convenience.
• D. Only when family agrees.

Answer: (B)

Decisions to withhold or withdraw treatments hinge on honoring the patient’s values and welfare. If the patient has decision-making capacity, their informed preferences and goals guide whether to continue aggressive interventions. When capacity is absent, decisions should reflect the patient’s previously expressed wishes through an advance directive or a designated surrogate making choices in line with substituted judgment or the patient’s best interests.

Nurses and clinicians discuss prognosis, goals of care, and options with the patient (when possible) and with family or a surrogate, ensuring that any action aligns with the patient’s values and relief of suffering. Decisions should be based on the patient’s rights and welfare, not on clinician convenience or unilateral family agreement. In summary, withholding or withdrawing treatment is ethically and legally appropriate when it reflects the patient’s preferences, directives, or best interests.