In a team meeting a nurse says, "I'm concerned about whether we are behaving ethically by using restraint to prevent one patient from self-mutilation, while the care plan for another self-mutilating patient requires one-on-one supervision." Which ethical principle most clearly applies to this situation?

Choice A reason: Fidelity involves faithfulness and keeping promises made to the patient. While it is important in maintaining the nurse-patient relationship, it does not address the ethical dilemma of why two different patients with similar behaviors are being treated with different levels of restrictiveness or resource allocation. Choice B reason: Beneficence is the duty to act in the best interest of the patient. While both interventions (restraints and one-on-one) are intended to benefit the patients by preventing harm, the core of the nurse's question is about the inconsistency and fairness of the treatment choices across the unit. Choice C reason: Autonomy concerns the patient's right to make their own decisions. While both interventions restrict autonomy, the nurse’s specific concern is the comparison between two patients, which shifts the focus from individual rights to the comparative fairness of the clinical decisions made by the team. Choice D reason: Justice in nursing ethics refers to the principle of fairness and the equitable distribution of resources and care. The nurse is questioning whether it is "just" or fair to provide a more intensive, less restrictive resource (one-on-one) to one patient while using mechanical restraints for another with the same clinical presentation.