Which term best describes the approach of applying multiple ethical principles (autonomy, beneficence, nonmaleficence, justice) in nursing ethics?

• A. Paternalism
• B. Justice
• C. Principlism
• D. Confidentiality

Answer: (C)

Principlism. This approach uses four guiding ethical principles—autonomy, beneficence, nonmaleficence, and justice—to evaluate and balance ethical issues in nursing. It treats these principles as coequal guides that inform decisions, especially when there are conflicts or trade-offs. By applying all four together, nurses consider the patient’s right to make their own choices (autonomy), the aim to promote good and help others (beneficence), the obligation to do no harm (nonmaleficence), and fair distribution of resources and burdens (justice). This framework is preferred because it provides a structured, flexible way to reason through complex clinical dilemmas rather than relying on a single rule.

Paternalism describes overriding a patient’s preferences for their perceived best interest, which conflicts with autonomy. Justice is one of the four principles, not the overall approach. Confidentiality concerns privacy of information, not the decision-making framework.