🏥 USMLE Exam Prep

A 72-year-old woman with end-stage renal disease requires urgent hemodialysis for hyperkalemia and fluid overload. She is alert, oriented x3, and understands the risks and benefits of dialysis but states, "I've lived a full life, and I'm ready to let nature take its course." Her daughter insists on dialysis. What is the most appropriate next step?

A Initiate emergency dialysis immediately based on the daughter's request.
B Obtain a court order to compel treatment, citing potential for self-harm.
C Respect the patient's decision after confirming her capacity for informed refusal.
D Consult with a psychiatrist to determine if depression is influencing her decision.

✓ Correct Answer: Option C

An adult patient with decision-making capacity has the right to refuse medical treatment, even if it is life-saving. Her stated understanding and orientation confirm her capacity, making her decision valid.

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