A client is unconscious following a traumatic injury and unable to make healthcare decisions. A durable power of attorney for healthcare document on file names the client's sister as the designated decision-maker. The client's spouse, who lives with the client, arrives and insists on making all treatment decisions instead. Which action should the nurse take?
- ADelay all treatment decisions until the spouse and sister reach agreement
- BSupport the sister as the decision-maker since she is the legally designated healthcare proxy per the advance directive
- CAsk the healthcare team to decide which family member seems more appropriate
- DFollow the spouse's instructions because a spouse is legally considered next of kin
Show answer & explanationAnswer & explanation
Correct answer: B. Support the sister as the decision-maker since she is the legally designated healthcare proxy per the advance directive
A durable power of attorney for healthcare legally designates a specific person to make decisions when the client is incapacitated, and this designation supersedes default next-of-kin hierarchies, including a spouse. The nurse's role is to advocate for the client's legally documented wishes by supporting the designated proxy's authority.
Why the other options are wrong
- A. Delaying care can harm the client; the legal proxy's authority should be recognized promptly.
- C. The care team should not subjectively choose a decision-maker when a legal document already specifies one.
- D. Spousal next-of-kin status does not override a legally executed healthcare power of attorney naming someone else.
Healthcare Power of Attorney Authority
A durable power of attorney for healthcare legally designates a specific decision-maker for an incapacitated client, and this designation takes precedence over default next-of-kin, including a spouse.
- POA document names decision-maker in advance
- Overrides typical next-of-kin hierarchy
- Nurse advocates for the client's legal designation
- Family disagreement does not change legal authority
Memory trick: The document names the voice—follow the paper, not the pressure.