A 27-year-old woman with major depressive disorder (MDD) was recently admitted voluntarily to an inpatient psychiatric hospital. Upon discharge, she is referred to a psychiatric-mental health nurse practitioner for follow-up. The client says she has tried several medications for MDD, but so far none has worked. The PMHNP recommends electroconvulsive therapy (ECT) as a treatment, explaining that the practice is safe and highly effective for treatment-resistant depression. The client declines, explaining she has heard too many negative things about ECT. Which of the following is the most appropriate response by the PMHNP?

Choice A reason: Threatening hospitalization violates patient autonomy and informed consent principles. Coercion is unethical and legally problematic. Choice B reason: Telling the patient to “trust me” dismisses her autonomy and does not allow her to make an informed decision. This approach undermines patient-centered care. Choice C reason: Respecting the patient’s autonomy while offering guidance exemplifies ethical practice. By acknowledging her concerns and exploring alternatives, the PMHNP fosters a collaborative therapeutic relationship and supports informed decision-making. Choice D reason: Pressuring the patient to accept ECT disregards her autonomy and can erode trust. This approach is coercive and not consistent with patient-centered ethical standards.