A nurse is assisting in the care of a client who has terminal cancer. Which of the following actions should the nurse take to promote the client's autonomy?

Autonomy is an ethical principle that recognizes a client’s right to make informed decisions about their own healthcare based on personal values, beliefs, and preferences. In terminal illness, preserving autonomy becomes especially important because clients may face complex decisions regarding comfort, quality of life, and end-of-life care. Nurses support autonomy by encouraging participation in care planning and respecting the client’s choices. This promotes dignity, trust, and patient-centered care. Rationale: A. Administering pain medication on a routine schedule supports comfort and symptom control, but it primarily reflects beneficence rather than autonomy. The focus is on doing good for the client rather than involving them directly in decision-making. Autonomy requires the client’s active participation in choices about their care. B. Following facility protocol when performing a procedure demonstrates adherence to standards of care and safety practices. Although necessary for safe nursing practice, it does not specifically promote the client’s right to self-determination. This action reflects professional responsibility rather than patient autonomy. C. Keeping an agreement to administer an antiemetic medication reflects fidelity, which involves keeping promises and maintaining trust in the nurse-client relationship. Although important ethically, it does not directly address the client’s involvement in making healthcare decisions. Autonomy focuses more on choice and control over treatment plans. D. Including the client’s input when setting treatment goals directly supports autonomy because it allows the client to participate in decisions affecting their care and quality of life. This ensures that treatment aligns with their values, priorities, and personal wishes, especially in terminal illness. Shared decision-making is a key expression of respecting patient autonomy.