The correct answer is Choice B.

Choice A rationale: Evaluating the possible courses of action and their potential consequences is an important part of the ethical decision-making process. However, this typically comes after identifying the individuals involved and understanding their rights and responsibilities. Therefore, while this is a crucial step, it is not the first one.

Choice B rationale: Identifying the individuals involved and their rights and responsibilities is the first step in the ethical decision-making process. This involves understanding who will be affected by the decision, what their interests are, and what duties or obligations apply. This provides a foundation for considering the ethical implications of different courses of action.

Choice C rationale: Consulting with other healthcare professionals for their opinions can provide valuable insights and perspectives. However, this is usually done after the individuals involved have been identified and their rights and responsibilities have been considered. Therefore, while this is an important part of the process, it is not the first step.

Choice D rationale: Reflecting on personal values and beliefs that may influence the decision-making process is an important part of ethical decision-making. However, this is typically done after identifying the individuals involved and their rights and responsibilities, and before evaluating the possible courses of action. Therefore, while this is a crucial step, it is not the first one.

Seek guidance from a nurse manager or ethics committee.

When faced with conflicting ethical principles, it is important for the nurse to seek guidance from a nurse manager or ethics committee. These resources can provide a structured and systematic approach to ethical decision-making, offering insights, perspectives, and potential resolutions to navigate the conflict. Involving these resources helps ensure a fair and comprehensive evaluation of the situation.

• Option a is not ideal as prioritizing one ethical principle over the other may lead to neglecting important considerations and not fully addressing the conflict.

• Option c is important and should be considered in the decision-making process, but seeking guidance from a nurse manager or ethics committee is crucial to navigate complex ethical conflicts.

• Option d is a step in the ethical decision-making process but may not provide sufficient guidance when facing conflicting ethical principles.

Respect the patient's autonomy and support their decision.

In this ethical dilemma, the nurse should respect the patient's autonomy and support their decision, even if it conflicts with what the nurse believes is in the patient's best interest. Respecting patient autonomy is a fundamental ethical principle, and patients have the right to make choices about their own healthcare. The nurse can provide information and support to help the patient make an informed decision, but ultimately, it is the patient's right to decide.

• Option b may be appropriate to provide information and advocate for the patient's best interest, but ultimately, the decision should respect the patient's autonomy.

• Option c can be considered, but the focus should be on respecting the patient's autonomy rather than seeking guidance from the healthcare provider to persuade the patient.

• Option d may be helpful in certain situations, but the primary consideration should be respecting the patient's autonomy and supporting their decision.

Respect the patient's religious beliefs and work with the healthcare team to find an alternative treatment plan.

In this situation, the nurse should respect the patient's religious beliefs and work collaboratively with the healthcare team to find an alternative treatment plan that accommodates both the patient's religious beliefs and their healthcare needs. Respecting religious beliefs is a crucial aspect of patient-centered care, and finding a solution that aligns with the patient's values is essential.

• Option a disregards the importance of respecting the patient's religious beliefs and does not promote patient-centered care.

• Option b is not appropriate as it violates the patient's autonomy and fails to respect their religious beliefs.

• Option d involves notifying the patient's family to change the patient's decision, which is not respectful of the patient's autonomy and rights.

Principlism

Principlism is an ethical decision-making model that uses a framework of ethical principles, such as autonomy, beneficence, nonmaleficence, and justice, to guide decision-making. It provides a structured approach that allows the nurse to evaluate the situation, consider the relevant principles, and make a decision based on ethical considerations. Principlism is particularly useful in situations that require immediate action, as it provides a systematic and comprehensive approach.

• Option a (utilitarianism) focuses on the greatest good for the greatest number of people, which may not be suitable for all ethical dilemmas and may not prioritize individual rights.

• Option b (virtue ethics) emphasizes the development of moral character and personal virtues, which may not provide immediate guidance in situations requiring urgent decision-making.

• Option d (ethical relativism) suggests that ethical standards are subjective and vary among individuals and cultures, which may not provide a clear framework for decision-making in time-sensitive situations.