In healthcare, the refusal to perform a high-risk procedure can be ethically justified under which principle?

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

Answer: (D)

Nonmaleficence, the obligation to avoid harming patients, guides decisions when an intervention could cause more harm than good. If a high‑risk procedure is unlikely to provide meaningful benefit or could lead to serious complications, proceeding risks harming the patient, so refusing to perform it protects them from unnecessary harm. Beneficence seeks to do good, but when the potential harm outweighs the potential benefit, not acting aligns with the duty to avoid harm. Autonomy concerns patient rights and informed choice and can influence decisions, but the fundamental ethical justification for refusing a dangerous procedure based on not causing harm remains nonmaleficence. Justice deals with fairness in distribution of care and isn’t the primary driver in this scenario.