🏥 USMLE Exam Prep

A 45-year-old patient with end-stage renal disease, fully informed about the risks and benefits, repeatedly refuses life-sustaining hemodialysis, stating she prefers quality of life over prolongation. She is oriented and articulate. What is the most ethically appropriate response from the medical team?

A Obtain a psychiatric consultation to assess for depression and decision-making capacity.
B Respect the patient's autonomous decision and initiate palliative care discussions.
C Persuade the patient to reconsider, emphasizing the life-saving nature of dialysis.
D Seek a court order to compel treatment, citing the patient's treatable condition.

✓ Correct Answer: Option B

A patient with decision-making capacity has the right to refuse medical treatment, even if it is life-sustaining. The physician's role is to ensure the decision is informed and to respect the patient's autonomy, shifting focus to comfort care.

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