If a nurse lies to a patient to avoid distress, which principle is violated?

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Lying to a patient to spare distress directly violates veracity—the obligation to be truthful in the clinician–patient relationship. Veracity underpins the patient’s ability to understand their situation, weigh options, and give informed consent, so deception erodes autonomy even when well-intentioned. Compassionate care supports delivering information honestly while providing support to cope with distress; avoidance of distress should not come at the cost of honesty.

Fidelity is about keeping promises and being loyal to duties, which can be implicated if a promise to be truthful was made, but the explicit breach here is truth-telling. Beneficence and autonomy are relevant as well—deception can hinder beneficial decision-making and patient self-determination—but the primary ethical violation is veracity.