A client with a history of major depressive disorder with psychotic features was rescued before jumping off a dam. The client is pacing, picking at the arms, and repeatedly mumbling, "I have to die. You cannot stop me." When the health care provider recommends electroconvulsive therapy (ECT) as the initial treatment, the client’s spouse says to the nurse, "I can’t allow such a cruel treatment. Why can’t they just give my spouse medication?" Which is the best response by the nurse?

Choice A reason: While it is true that untreated suicidal depression can be fatal, this response is confrontational and increases fear without addressing the spouse’s concern. Choice B reason: Assuring the spouse that the client will not feel anything oversimplifies ECT. Though anesthesia prevents pain, this statement dismisses the spouse’s fears and does not encourage discussion. Choice C reason: While medications do take weeks to be effective, simply giving this fact does not address the emotional concerns and fears about ECT being “cruel.” Choice D reason: This response acknowledges the seriousness of the illness, explains why ECT may be necessary, and opens dialogue by inviting the spouse to share concerns. It is therapeutic, informative, and supportive, making it the best choice.