As a general rule, ethical practice in patient care requires clinicians to balance autonomy with other principles. Which pairing is most commonly cited as a guiding tension?

• A. Autonomy and Justice
• B. Autonomy and Beneficence
• C. Autonomy and Nonmaleficence
• D. Autonomy and Confidentiality

Answer: (B)

Balancing respect for patient choices with acting in their best interests drives much of everyday clinical ethics. Autonomy means patients have the right to decide what happens to their bodies after informed discussion, while beneficence requires clinicians to promote well-being and prevent harm. The tension shows up when a patient’s informed preference may not align with what the clinician believes will benefit them. In such cases, you prioritize informed consent and shared decision-making, supporting the patient’s choice if they are competent. If the patient lacks decision-making capacity, beneficence and surrogate decision-making guide actions to protect welfare. Other ethical tensions, like justice or confidentiality, matter as well, but autonomy paired with beneficence is the most commonly cited guiding tension.