The parents of a 24-week gestation infant request aggressive treatment despite a grim prognosis. This is an example of which ethical principle?

• A. Respect for Autonomy
• B. Beneficence
• C. Nonmaleficence
• D. Justice

Answer: (A)

Respect for autonomy is demonstrated when the family’s values and preferences guide the care decisions, even for a patient who cannot speak for themselves. In neonatal ethics, parents act as surrogate decision-makers for their newborn. When they request aggressive treatment for a 24-week gestation infant with a grim prognosis, it reflects their right to determine what is in the child’s best interest based on their beliefs and hopes, provided they have been given complete, understandable information about prognosis, risks, benefits, and alternatives. The clinician’s role is to honor that surrogate decision-making while ensuring informed consent and offering support, rather than unilaterally imposing a different plan. While beneficence, nonmaleficence, and justice all play roles in care decisions, the scenario centers on the parents’ authority to decide the course of treatment for their child.