A 21-year-old man who has schizoaffective disorder tells his PMHNP that he wants to discontinue his psychiatric medications. He is not currently psychotic and he does not pose a danger to himself or others. What should his nurse practitioner do next?

Choice A reason: While education and discussion about the risks of discontinuing medication are important, trying to convince the patient without respecting autonomy may undermine trust. This approach is paternalistic and does not honor the patient’s legal rights. Choice B reason: Predicting hospitalization may be perceived as coercive and fear-inducing. It is not appropriate unless there is clear evidence of imminent risk. The patient is currently stable and competent, so this approach is not justified. Choice C reason: Competent adults have the legal right to refuse medical treatment, including psychiatric medications. The PMHNP should assess the patient’s decision-making capacity and, if intact, respect his autonomy. The provider can offer education and support but must honor the patient’s informed choice. Choice D reason: This response is inappropriate and stigmatizing. It assumes incompetence without assessment and threatens involuntary hospitalization without cause. Such actions violate ethical and legal standards in psychiatric care.