Dr. Anderson is struggling with Mark's decision to refuse hemodialysis because it conflicts with which ethical principle?

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

Answer: (B)

Beneficence is the principle at issue here: it’s the obligation to act in the patient’s best interest and to promote their well‑being. Dr. Anderson believes that dialysis would benefit Mark by improving health and survival, so he feels tension between doing what would help (beneficence) and honoring Mark’s stated wish to refuse treatment. The physician’s drive to provide what would be beneficial creates the struggle when a patient refuses care.

Context helps: while autonomy is about respecting a competent patient’s right to refuse, beneficence focuses on the clinician’s duty to promote good outcomes. Nonmaleficence is about not causing harm, which is relevant but not the central motive driving the physician’s conflict here. Justice concerns fair distribution of care or resources, which isn’t the primary issue in this scenario.