Final answer:
The nurse is guided by the principle of autonomy to support the patient's right to self-determination regarding her health care decisions. Autonomy ensures the patient's wishes are respected even if they contrast with family desires. The nurse's role is to advocate for the patient's ability to make informed decisions about the end of care.
Step-by-step explanation:
In the scenario presented, where a patient is hesitant to communicate her wishes due to fear of upsetting her family, the nurse is guided by the principle of autonomy. This principle emphasizes that patients have the right to make decisions regarding their own health care. The role of the nurse, in this case, is to support the patient's right to self-determination and to assist her in expressing her desires about the end of care, even in the face of potential family disagreement.
The principle of beneficence also plays a role by guiding the nurse to act in ways that benefit the patient. However, it is the patient's understanding of what constitutes a benefit to herself that must be respected, in line with her autonomous wishes. In such delicate situations, the nurse must navigate both the patient's autonomy and the benefits of treatments or discontinuation of care.
Ensuring that the patient feels empowered to speak her mind without fear is a core aspect of the ethical practice of nursing and confirms the importance of the principle of autonomy in healthcare decisions.