What was the primary motivation for Lillian Wald to establish the Henry Street Settlement in 1893?

Rationale:

A. Autonomy is correct because it is the ethical principle that recognizes the patient’s right to make decisions about their own body and medical care, even if those decisions conflict with the family’s wishes. Supporting the patient’s choice respects their personal values, dignity, and self-determination. In cases of terminal illness, honoring autonomy is central to ethical nursing practice.

B. Nonmaleficence is incorrect because, while this principle involves “doing no harm,” it does not specifically address the patient’s right to make independent decisions. Supporting autonomy may sometimes involve interventions that the nurse perceives as causing harm, but ethically, the patient’s informed choice takes precedence.

C. Justice is incorrect because it relates to fairness and equitable distribution of resources and care. While important in healthcare, justice does not directly guide decisions about respecting an individual patient’s treatment preferences.

D. Beneficence is incorrect because it focuses on acting in the patient’s best interest to promote good. While beneficence is important, it can sometimes conflict with autonomy if the nurse or family believes life support continuation is “beneficial.” Ethical practice prioritizes respecting the patient’s autonomous decisions even when beneficence and the nurse’s personal judgment differ.

Rationale:

A. By ensuring that all patient data is stored on paper for easy access is incorrect because paper records are prone to loss, illegibility, and delays in information sharing. Modern clinical decision-making relies on electronic health records (EHRs) for accuracy, accessibility, and integration.

B. By allowing multiple disciplines to access patient data simultaneously is correct because EHRs enable real-time access to comprehensive patient information, including lab results, vital signs, and medical history, by various healthcare providers. This supports informed, timely, and coordinated clinical decisions, promotes interdisciplinary collaboration, and reduces errors caused by miscommunication or fragmented records.

C. By reducing the need for patient interaction is incorrect because EHRs are tools to enhance care, not replace the nurse-patient relationship. Effective clinical decision-making still requires assessment, communication, and direct observation of the patient.

D. By eliminating the possibility of data breaches is incorrect because while EHRs include security measures, they do not completely eliminate the risk of unauthorized access or cyberattacks. Data security is an ongoing concern that requires vigilance, policies, and safeguards.