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Safety or autonomy. An ethical issue for clinical gerontological nurses.

A common dilemma is whether to ensure a safe environment for the older person or to allow the older person to continue to live independently in an environment where personal safety may not be ensured. Conflicting opinions between marginally competent older adults and adult children regarding satisfactory living arrangements involve a forced choice between the moral principles of beneficence and autonomy. An ethical dilemma cannot be resolved on the basis of values alone. Pertinent ethical principles must be applied and an ethical theory used to guide the resolution. Autonomy is considered the supreme ethical principle in Western culture. The decision to set it aside, even to promote safety, takes rigorous ethical justification.