A patient with cognitive impairment can still exercise autonomy if

A patient with cognitive impairment can still exercise autonomy if

• A. They cannot.
• B. They express a clearly stated preference or have a valid advance directive.
• C. The nurse decides for them to protect safety.
• D. The family makes decisions without patient input.

Answer: (B)

Autonomy remains intact for someone with cognitive impairment when their own wishes are known and respected. If the person can clearly express a preference, that choice should guide care. If there is a valid advance directive, it communicates the person’s values and treatment preferences for times when they may not be able to speak for themselves, and clinicians should follow it. These avenues honor the individual's agency and ensure care aligns with what they would want. Relying on a nurse to decide solely to protect safety, or letting family decide without patient input, undermines autonomy and sidelines the patient’s voice. Even with impairment, involving the patient as much as possible and using their expressed preferences or directives ensures their rights and values are central to care.

Autonomy remains intact for someone with cognitive impairment when their own wishes are known and respected. If the person can clearly express a preference, that choice should guide care. If there is a valid advance directive, it communicates the person’s values and treatment preferences for times when they may not be able to speak for themselves, and clinicians should follow it. These avenues honor the individual's agency and ensure care aligns with what they would want.

Relying on a nurse to decide solely to protect safety, or letting family decide without patient input, undermines autonomy and sidelines the patient’s voice. Even with impairment, involving the patient as much as possible and using their expressed preferences or directives ensures their rights and values are central to care.