What principle supports honoring patient autonomy when family demands care be withheld?

• A. Beneficence always overrides patient wishes.
• B. Respect for patient autonomy and, when appropriate, surrogate decision-making per patient wishes.
• C. Family wishes override patient wishes.
• D. Justice determines withholding.

Answer: (B)

Respect for patient autonomy guides decisions when a patient makes their own medical choices, including the option to refuse or withhold treatment. If the patient is competent, their wishes take precedence, even if family disagrees. When the patient lacks capacity, a surrogate decision-maker should follow what the patient would have wanted, usually based on prior expressed wishes or, if not known, the patient’s best interests. That combination—honoring the patient’s autonomy and, when appropriate, surrogate decisions aligned with the patient’s wishes—best fits the scenario.

Beneficence is important but not absolute; it doesn’t justify overriding an competent patient’s choice. Family wishes overriding patient autonomy is not appropriate, and justice concerns fairness in treatment distribution rather than dictating an individual withholding decision.