Which statement is the first maxim among the three principles?

• A. Respect for Autonomy > beneficence and nonmaleficence
• B. The interests of others may > respect for autonomy
• C. If the harm = benefits, then nonmaleficence > beneficence
• D. Autonomy equals beneficence

Answer: (A)

Respect for autonomy is treated as the primary guiding principle because it centers on the individual’s right to make informed decisions about their own body and medical care. When a patient is competent, their choices should be respected, and consent must be obtained; this gives real moral authority to the patient’s values and preferences. Beneficence and nonmaleficence still matter, but they operate within the framework set by autonomy. If a patient freely chooses a course of action, even if it seems to involve less beneficence or some harm, clinicians should honor that choice unless there is a compelling reason to intervene (such as incapacity or public health concerns). This is why the statement that autonomy takes precedence over beneficence and nonmaleficence best captures the intended hierarchy. The other options misstate the relationships or conflate the principles, such as implying others’ interests always override autonomy or equating autonomy with beneficence.