An 18-year-old client in the emergency department is scheduled for an appendectomy. Although the client's parents advocate for the surgery, the client declines the procedure. Which of the following ethical principles is the nurse displaying by respecting the client's decision?

A. Nonmaleficence: Nonmaleficence refers to the obligation to do no harm and to avoid causing injury. While this principle is always important in healthcare, the central issue in this scenario involves respecting the client's decision-making rights rather than directly preventing harm. B. Autonomy: Autonomy is the ethical principle that supports a client's right to make their own healthcare decisions, even if those decisions differ from the wishes of others, including family members. Respecting the 18-year-old client's choice to decline surgery honors their legal and moral right to self-determination. C. Beneficence: Beneficence involves taking actions that promote the well-being and best interests of the client. While advocating for the surgery could be seen as promoting beneficence, the nurse’s primary ethical duty in this situation is to respect the client’s independent decision. D. Justice: Justice is concerned with fairness and the equitable distribution of healthcare resources. Although justice is a core ethical principle, it does not directly apply to an individual’s right to refuse treatment as seen in this situation.