Chart — Professional Practice
Ethical Principles Chart
The seven principles every nursing exam draws from — each with a definition, a bedside example, and the recognition keyword — plus the four classic collisions where two principles fight and the question asks which one wins.
Educational use only. Genuine ethical conflicts at the bedside go to the provider, chain of command, and ethics committee — this chart is for understanding the vocabulary, not adjudicating real cases alone. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
The Seven Principles
| Principle | Definition | Bedside Example | Recognize It By |
|---|---|---|---|
| Autonomy | The patient's right to make their own decisions | A competent patient refuses chemotherapy; the nurse ensures the refusal is informed and respects it | Self-determination — refusal, consent, AMA |
| Beneficence | Acting in the patient's best interest — doing good | Arranging a dietitian consult for a struggling diabetic patient before discharge | Promoting good, advocating benefit |
| Nonmaleficence | Do no harm — and prevent harm | Questioning a dose that's ten times the usual; refusing to work impaired; double-checking high-alert meds | Avoiding/preventing harm |
| Justice | Fairness in the distribution of care and resources | Triaging by acuity rather than by who complains loudest; equitable care regardless of insurance status | Fair allocation, equal treatment |
| Fidelity | Keeping promises and commitments | Saying you'll return with pain medication in 15 minutes — and returning in 15 minutes | Faithfulness to your word |
| Veracity | Telling the truth | Admitting a medication error to the patient and provider; answering prognosis questions honestly within your role | Truthfulness — even when hard |
| Accountability | Answering for one's own actions | Owning a missed assessment rather than blaming the workload; 'the provider ordered it' doesn't transfer responsibility | Personal responsibility |
The Classic Collisions
| Collision | Scenario | How It Resolves |
|---|---|---|
| Autonomy vs beneficence | Competent patient refuses a life-saving transfusion | Autonomy wins when the patient is competent and informed — educate, verify understanding, respect the decision |
| Veracity vs family wishes | Family asks the team to hide a terminal diagnosis from the patient | The patient's right to truth comes first; explore the family's fears and involve the ethics committee if needed |
| Justice vs beneficence | One ICU bed, two deteriorating patients | Allocate by clinical criteria (acuity, likelihood of benefit) — not relationship, status, or order of arrival |
| Nonmaleficence vs beneficence | Painful debridement that promotes healing | Benefit must outweigh harm — premedicate, explain, and proceed; intended good with managed harm is ethical care |
Exam Traps
- ✦Fidelity vs veracity: fidelity is keeping promises; veracity is telling the truth — questions swap them deliberately.
- ✦Beneficence vs nonmaleficence: doing good vs preventing harm. Stopping an unsafe action is nonmaleficence.
- ✦A competent, informed patient's refusal is an autonomy answer — not an excuse to 'educate harder' until they agree.
- ✦Justice scenarios are about allocation (beds, triage, time) — fairness by clinical criteria.
- ✦Accountability answers own the error; any option that shifts blame or hides the mistake is wrong.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with ANA Code of Ethics & Scope/Standards of Practice · NCSBN · HIPAA (U.S. HHS). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →