If a patient has an advance directive stating a desire for DNR, but family pressure persists, what is the ethical course of action?

Honoring the advance directive despite family wishes is the ethical course of action because advance directives are legal documents that reflect a patient's wishes regarding their medical treatment in situations where they may be unable to communicate those wishes themselves. The ethical principle of autonomy supports the rights of patients to make informed decisions about their own healthcare, and these decisions must be respected as long as they are valid and legally binding.

In this scenario, the advance directive clearly indicates the patient’s desire for a Do Not Resuscitate (DNR) order. Respecting this decision aligns with the ethical obligation to prioritize the patient’s preferences and rights over familial distress or pressure. Upholding the advance directive can help prevent potential conflicts, emotional distress for healthcare providers, and possibly legal ramifications arising from disregarding a legally valid document.

Additionally, while consulting the hospital's legal team, the attorney, or contacting a chaplain may provide support for navigating the situation, it does not address the primary responsibility of healthcare professionals to respect the patient’s wishes as documented in their advance directive. Thus, honoring the advance directive is the most ethically sound choice in this scenario.