ting competency, kindness, and so forth unfortunately may, at times, conflict with one another. Thus, an ethnical decision based upon beneficence often may be complex.
2. Nonmaleficence: Nonmaleficence requires that a nurse do nothing that is harmful (Milner, 1993, p. 23; Corley, Selig, and Ferguson, 1993, p. 120). Within the context of the concept of a right to die, the ethical principle of nonmaleficence could be interpreted to mean that a nurse should not assist suicide by injecting a consenting patient with a lethal substance (Kowalski, 1993, p. 70). Conversely, the failure by a nurse to communicate to other professionals a patient's stated intent to take her or his own life might also be considered by some people to be nonmaleficence in an ethical context (Kowalski, 1993, p. 71).
3. Autonomy: Autonomy requires that a nurse be independent in action and decision making, and accept responsibility for her or his actions and the consequences of those actions (Milner, 1993, p. 23). Autonomy, however, may also be interpreted to mean that the patient has a right of self determination concerning actions related her or his own life (Catalano, 1992, p. 93).
4. Justice: The principle of justice requires a nurse to be fair and equitable to all persons (Milner, 1993, p. 23). If all people are considered to be of equal value, then a nurse is required to consider the desires of family members and health care coworkers, as well as those of the patient in reaching decisions related to the patient (Corley, Selig, and Ferguson, 1993, pp. 120 121).
5. Fidelity: Fidelity requires a nurse to both keep promises made to others and to protect the trust placed by others in her or him (Milner, 1993, p. 23). This requirement may be interpreted to mean that a nurse is bound to honor formal expressions of patient autonomy, such as an advance directive related to the termination of care
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