A terminal patient with a fulminating leg wound needs surgery, yet there is no guarantee the patient will survive the procedure. The nurse realizes that which of the following actions would support the ethical principle of beneficence?
1. Do not conduct the surgery and determine other treatment approaches.
2. Conduct the surgery.
3. Explain that the surgery is needed and every effort will be done to keep the patient alive.
4. Tell the patient that offering surgery was an error and that treatment will be done with medications and therapy.
Do not conduct the surgery and determine other treatment approaches.
Rationale: Beneficence means to do or promote good. It is different from nonmaleficence, or the duty to not inflict harm. It is sometimes difficult when caring for patients to distinguish between preventing harm and providing benefit. The surgery should not be conducted and other treatment options should be determined; when the duty not to inflict harm conflicts with the duty to provide benefit, there is support for the view that the obligation not to injure others is greater than the obligation to benefit them. Patients at the end of their lives may be vulnerable to harm when they receive unwanted or unnecessary interventions, are overtreated with technological interventions that serve only to prolong dying, and when treatments are withdrawn without their consent or agreement. The surgery should not be done with the promise of keeping the patient alive. The statement that the offer of surgery was a mistake should not be made to the patient.
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