A 25-year-old man with obesity is admitted to the ICU with sepsis secondary to community-acquired pneumonia. Blood pressure is 80/40 mm Hg, heart rate 108 beats/min, respiratory rate 24 breaths/min, pulse oxymetry 90% on 4-liter nasal canula, and lactic acid level 5.6 mmol/L. The ICU team requests the patient’s permission to insert a central line through an internal jugular approach to begin pressors. After being informed about the indications, risks and benefits, the patient refuses to authorize it and requests that all of the necessary drugs be administered through a peripheral intravenous line. The intensivist refuses to administers the pressors through the peripheral IV because of the risk of infiltration with the potential loss of limb.
The intensivist is exercising which of the following ethical priciples?
A. Non-abandonment versus nonmaleficence
B. Bioethics versus legal obligation
C. Autonomy versus nonmaleficence
D. Autonomy versus beneficence
答案解析：
通常与伦理决策过程相关的伦理原则是自主权、善行、非恶意和法律义务。自主性通常优先于其他因素，即使其他治疗选择是必要的（善行）和被解释的（法律义务）。非恶意是医生拒绝同意对患者有害的治疗的权利。如果患者不同意治疗，在其他医生同意接受治疗之前，医生不能放弃该患者。对于该患者，尊重患者的意愿（自主性）和医生不提供有害（非恶意）干预的愿望是存在的。
正确答案：C
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