Answer the question for the journal -this is for health ethics and law class

The question for the second journal entry is
A 64-year-old woman with multiple sclerosis (MS) is hospitalized. The team feels she may need to be placed on a feeding tube soon to assure adequate nourishment. They ask the patient about this in the morning and she agrees. However, in the evening (before the tube has been placed), the patient becomes disoriented and seems confused about her decision to have the feeding tube placed. She tells the team she doesnt want it in. They revisit the question the next morning, when the patient is again lucid. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure.
Is this patient competent to decide? Which preference should be honored? What factors would you take into account in your decision? Which legal and ethical principles prevail in the option you have chosen? Use one of the ethical decision-making methods to build your answer.

please integrate the following concepts when appliciable :

Informed consent, Patients autonomy, Battery, Paternalism, Instructional advance directives, Proxy directive

Competence an individuals ability to make medical decisions requires the
rational, mentally-mature decision-maker to be 1free from any internal or external
constraints that might impede his/her ability to understand the medical situation,
prognosis and treatment options and the risks of treatment and non-treatment, and
2be able to make a decision that reflects his/her long-term, settled values.
What can be internal and external constraints?

Competence should be judged primarily on the process of reasoning, rather
than the outcome/decision of the patient.

Standard of competence varies based on the expected harms and benefits of
the patients choice
E.g. consenting to a low-risk procedure that will save your life requires minimal
competence vs. refusing the same treatment would require maximal competence.

and finally and most importantly, Use one of the ethical decision-making methods to build your answer ( the two models are attached).

Do NOT reference or use any books. only use acadimaic sources that can be accessable online.
the only 2 books that can be cited are the Required textbooks
1-Biomedical Ethics: A Canadian Focus (2e) 2013 by Johnna Fisher
2-Canadian Medical Law: An introduction for Physicians, Nurses and other Health Care Professionals, 4th Edition
By: John C. Irvine, Philip H. Osborne, Mary Shariff

if you have any questions, please let me know.