A patient with terminal illness requests withdrawal of life-sustaining treatment. What is the nurse's primary ethical consideration?

• A. Respect for patient autonomy and relief of suffering.
• B. Beneficence by physician decision alone.
• C. Nonmaleficence.
• D. Justice in resource allocation.

Answer: (A)

The main idea being tested is respecting the patient’s right to make their own care decisions. When a patient with a terminal illness asks to withdraw life-sustaining treatment, the nurse should honor that choice if the patient is competent to decide, ensuring the decision is informed and voluntary. This reflects autonomy—the patient’s self-determination—as the guiding ethical principle. At the same time, the nurse helps prevent suffering by arranging appropriate comfort measures and ensuring clear communication about what withdrawal means and what care will continue to address symptoms.

In practice, this means confirming capacity, providing information about the withdrawal process, supporting the patient’s goals of care, and coordinating palliative measures. The other considerations—beneficence, nonmaleficence, and justice—play a role, but they do not supersede the patient’s autonomous decision in this context. Beneficence by physician decision alone would sidestep the patient’s preferences; nonmaleficence focuses on avoiding harm but doesn't override autonomy here; justice concerns resource allocation rather than the individual care choice.