The nurse is caring for a client with end-stage kidney disease. The client says, “I have decided that I don’t want any more dialysis or treatments. This is just prolonging the inevitable.” The nurse responds, “You have every right to do so. I will notify the nephrologist of your wishes.” Which ethical principle is being demonstrated by the nurse?
Autonomy is respecting the rights of others to make their own decisions regarding care. Justice is the duty to distribute resources or care equally without regard to personal attributes (e.g., the nurse devotes equal attention to a homeless client who attempted suicide and to the client with a stroke). Fidelity or non-maleficence is maintaining loyalty and commitment to the client and doing no wrong to the client. The concept of fidelity includes keeping promises made to the client (e.g., the client asks the nurse not to reveal a cancer diagnosis to the family because he is concerned that his family will insist on aggressive treatment). Beneficence is the duty to act to promote the good of others (i.e., spending extra time to talk with a lonely, elderly client).
