An intern orders intravenous morphine for a case of head injury. Knowing that morphine may be harmful in the case, the nurse does not administer the injection but asks for confirmation from the senior Doctor. She has followed the bioethics principle of

Appeared in: GMCH - 2015

Explanation

The core ethical principle of non-maleficence is to 'do no harm' and to prevent harm from happening.
In this scenario, the nurse identified that administering morphine to a patient with a head injury could be harmful.
Morphine can cause respiratory depression, leading to increased intracranial pressure (ICP), and can also cause pupillary constriction (miosis), which masks crucial neurological signs.
By withholding the medication and escalating the concern to a senior doctor for confirmation, the nurse actively prevented potential harm to the patient, directly applying the principle of non-maleficence.

Why Other Options Were Wrong

Option A: Sincerity is a personal virtue related to truthfulness (veracity), but it is not considered one of the four primary principles of bioethics (autonomy, beneficence, non-maleficence, justice).
Option C: Autonomy refers to respecting a patient's right to make their own informed decisions about their care. The scenario does not involve a patient's decision but rather a professional conflict about the safety of a prescribed treatment.
Option D: Fidelity means being faithful to one's commitments and responsibilities. While the nurse is acting faithfully to her duty to protect the patient, the most specific and primary principle demonstrated is the prevention of harm.

Related Visual

Clinical Relevance

Nursing practice connection: Knowing Application of Bioethical Principles in Nursing Practice helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
This scenario highlights the critical role of the nurse as a patient advocate and the last line of defense against medication errors.
Nurses have a professional and ethical responsibility to question any order that they believe may be unsafe or harmful to the patient, regardless of who wrote the order.
This duty is a core component of the 'five rights' of medication administration (right patient, right drug, right dose, right route, right time), which includes verifying that the medication is appropriate for the patient's condition.

How to Approach the Question

First, identify the core action performed by the nurse in the clinical scenario. Here, the nurse is preventing a potentially harmful action.
Analyze the keywords in the stem: 'harmful', 'head injury', 'morphine', 'does not administer'. This points to a situation where risk is being avoided.
Next, review the definitions of the bioethical principles provided in the options.
Match the nurse's action (preventing harm) with the most fitting principle. Non-maleficence directly translates to 'do no harm'.
Systematically eliminate the other options by comparing their definitions to the scenario. Autonomy is about patient choice, Fidelity is about loyalty, and Sincerity is not a core bioethical principle.

Concept Tested & Keywords

Concept Tested: Application of Bioethical Principles in Nursing Practice
Stem keywords: head injury, morphine, nurse, bioethics principle, intern, senior Doctor
Lead-in keywords: followed the bioethics principle of
Clinical cues: The nurse's action of questioning a potentially harmful order from a junior doctor highlights the professional responsibility and role as a patient advocate.

Question ID

QAw5lyI4jnZHAMJgDSAL3L

Reference Book

E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 81-83

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13068-13070

E6 Pharmacology Nursing Lilley 11e Part 1 p. 74-76

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