"If a patient with known and proven beyond reasonable doubts CHF chooses not to follow salt-free diet, it is his business as long as he is informed about what happens as a result (no improvement in his condition doesn't matter how many miracle pills he is taking and eventually death). Now, if that patient is in health care facility, has an acute CHF exacerbation directly related his refusal to follow salt-free diet, has direct provider order for that diet and still demands salt, would it be ethical to allow him to, essentially, aid to his disease in the name of keeping him "satisfied"? Or, even more, try to influence provider into dropping the diet order and not providing salt-free food at all under the same premice (recently witnessed practice in LTC)?"
I have witnessed in LTC because of state regulations, if diabetics want pancakes with ice cream topping for breakfast, lunch, and dinner, the facilities have to attempt to accommodate these requests because the LTC facility is their home, and if they were living in the community and that was what they wanted they could have it. In theory I agree, but often these people are not cognitively capable of making appropriate decisions, hence the LTC facility. So why are they allowed to make inappropriate meal choices? If their guardian signs off on it, okay, but otherwise, I don't think unwise decisions are appropriate. If they wanted to go outside in only their underwear in 20-degree below zero weather, should we allow it? If they wanted to drink bleach, should we allow it? It is their right, because they want to do it, correct? Competent adults are allowed to make bad decisions, but not all adults are competent (even some who have not been declared incompetent.)