This assignment addresses the implications of an ethical dilemma encountered in practice using an appropriate reflection model. The assignment will highlight ethical theories and four guiding ethical principles, such as autonomy, beneficence, paternalism, and non-maleficence. The two fundamental principles that will be discussed in depth will be autonomy and beneficence and their impact on practice. I will use Borton's (1970) reflective model, taken from Jasper (2003). One incident, which occurred during the internship, involved a patient's decision to withdraw from active treatment. Hopefully, by exploring the incident in depth, you will gain a greater understanding of moral and ethical principles. All names that will be used within the text are pseudonyms. This is to ensure confidentiality, as stated by the Nursing and Midwifery Council (NMC 2004). Health care workers have a legal and moral obligation to care. They must respect the patient's decision even if they themselves find it difficult (Butts and Rich 2005). The decisions are not without problems. They must be rationalized, since there are many conflicting thoughts, which must be recognized. The dilemma occurred during district nurse (DN) placement in the community. It involved a 72-year-old woman we'll call Clare, who made the utilitarian decision to forgo active treatment. It was an independent decision and the DN and I had to respect his choice, but we were concerned about the practicalities associated with his judgment. Attempting to relieve pain and suffering is a primary responsibility of the nurse (Butts and Rich 2005). Clare was extremely weak and was unable to take the sta...... middle of paper ...... posted 1 : concepts and definitions. British Journal of Nursing, 12(1), 43-47.Singleton, J., & McClaren, S. (1995). Ethical frameworks of health care. London: Mosby.Tadd, W. (1998). Ethical problems in nursing and midwifery practice. Mills: Macmillan Press.Thomas, A. (n.d.). Patient autonomy and cancer treatment decisions. Retrieved from http://www.internurse.com on October 26, 2005.Thompson, D. (1996). Concise Oxford Dictionary. (9th ed.). London: BCA.Thompson, R., Melia, K., & Boyd, K. (2004.). Nursing ethics. (4th ed.). Edinburgh: Churchill Livingstone.Wilkinson, J. (1997). Develop an analysis of the concept of autonomy in nursing practice. British Journal of Nursing, 6(12), 703-707. Wilmot, S. (2003). Ethics, power and politics: the future of nursing in the National Health Service. Basingstoke: Palgrave.