A client with a suspected diagnosis of renal cancer is ordered to undergo a renal biopsy to confirm the diagnosis. The client informs a nurse that she will not sign the informed consent form. Which action should the nurse take?

A client with a suspected diagnosis of renal cancer is ordered to undergo a renal biopsy to confirm the diagnosis. The client informs a nurse that she will not sign the informed consent form. Which action should the nurse take?

• A. Notify a physician that the client refuses to give consent.
• B. Proceed with the biopsy anyway.
• C. Sign the consent form for the client.
• D. Document the refusal and proceed without consent.

Answer: (A)

Respecting the patient’s right to autonomy and the informed consent process is being tested. When a client refuses to sign consent for a procedure, the nurse must inform the physician of the refusal so the physician can review the information with the patient, address questions, and determine how to proceed. The procedure cannot be done without valid consent, and the nurse cannot sign for the patient or proceed without consent. If the patient truly lacks decision-making capacity, the physician would involve a legally authorized representative or pursue appropriate steps, but that decision is made by the physician, not the nurse performing the procedure.

Respecting the patient’s right to autonomy and the informed consent process is being tested. When a client refuses to sign consent for a procedure, the nurse must inform the physician of the refusal so the physician can review the information with the patient, address questions, and determine how to proceed. The procedure cannot be done without valid consent, and the nurse cannot sign for the patient or proceed without consent. If the patient truly lacks decision-making capacity, the physician would involve a legally authorized representative or pursue appropriate steps, but that decision is made by the physician, not the nurse performing the procedure.