A nurse is having difficulty with the decision for aggressive cancer therapy in an elderly client, wondering if the therapy will actually be more harmful than the disease and knowing that the client will be subjected to harmful chemicals

Question

This nurse is struggling with which of the following principles?
1. Autonomy
2. Justice
3. Beneficence
4. Nonmaleficence

Answer 1

Correct Answer: 4
Rationale 1: Autonomy refers to the right to make one's own decisions. That is not what the nurse is having an ethical dilemma about.
Rationale 2: Justice is often referred to as fairness. That is not what the nurse is having an ethical dilemma about.
Rationale 3: Beneficence means "doing good." In this case the benefits are not known, making the harm more real. While aggressive cancer therapy is difficult to endure, and given the age of the client, this case is a suggestion of beneficence but there is a more appropriate option available.
Rationale 4: Nonmaleficence is duty to "do no harm." Doing intentional harm is never acceptable in nursing. Placing a client at risk of harm is what is depicted in this scenario, and it occurs as a known consequence of a nursing intervention or some other type of treatment. It is unknown how much therapy will be of benefit to the client or whether it will actually do more harm.