ethical issue paper

Yes, he should discuss with the doc other medications that won't effect his virility. Also you could discuss his weight, alcohol use, diet, exercise, coping techniques, salt use with him.

I think we would all agree he needs some kind of care. I couldn't argue to support the opposite view unless his goal is to stroke out while having sexual intercourse. I would pursue the diet, exercise avenues and a consultation with a naturopath. There are nutritional things that can improve blood pressure. He needs to have a whole bunch of options. Ultimately, the ball will be in his court.

I think you are stuck on the principle of autonomy and forgetting that all the principles are inter-related. A client cannot make an informed (autonomous) decision without good info. The nurse must present info in a manner that does not intimidate (trust/veracity/fidelity). Is he aware that HTN causes strokes, which can be worse than sudden death by MI? What about drugs that counter the effects? Alternative sexual methods? Sex therapy? Look up impotence on web and see where that leads. Good luck.