How should a nurse respond to a patient who refuses life-sustaining treatment due to religious beliefs?

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Respecting patient autonomy is fundamental. When a patient has decision-making capacity and chooses to refuse life-sustaining treatment due to religious beliefs, the nurse should honor that choice, while ensuring the patient understands the consequences and remains engaged in care planning.

First, verify capacity: the patient must understand the information about the treatment, appreciate the consequences of accepting or refusing, be able to reason about the options, and communicate a consistent choice. If capacity is present, support the decision without coercion, and discuss alternatives that align with the patient’s beliefs—such as emphasis on comfort measures, pain and symptom control, and spiritual support. Provide clear information about what the refusal means for prognosis and ongoing care, and answer questions to reduce misunderstandings.

Document thoroughly: the patient’s expressed wishes, the information provided, the capacity assessment, who was informed, and any alternatives offered. Ensure the decision is revisited if clinical circumstances change. Involve the ethics committee or a trusted colleague if there is conflict, uncertainty, or disagreement among family, staff, or the patient, to navigate the situation with fairness and respect for rights.

If the patient lacks capacity, follow established surrogate decision-making processes and use known wishes or best interests. Do not override a capable patient’s decision, ignore the request, or withdraw care without discussion, as that would undermine patient rights and the professional duty to respect autonomy.