bioethical principles in healthcare

8/13/2019 Bioethical Principles in Healthcare

1/4

Bioethical Principles in Healthcare

1. Principle in AutonomyOne of the most important principles in bioethical sphere, particularly in medical ethics, is the concept

of autonomy. The term autonomy comes from the greek autos ( self) and nomous ( governance). In thecontext of health care, the principle of autonomy specifically applies to respect for the patientsautonomy. Health care providers should view and treat every patient as an independent, self-governingas well as self-determining being. These are the following specific actions that medical prefessionals cando in accordance with the principle in dealing with their patients.

1) Obtaining informed consent for treatment.

2) Facilitating patient choice regarding treatment options

3) Allowing the patient t refuse treatment

4) Disclosure by the provider of personal medical information, diagnoses, and treatment options to theinvolved patients/.

5) Maintaining confidentiality.

The basic right to self-determination is said to put a clear boundary with regards to what physicians,nurses, and other health care professionals can justifiably do to patients under their care. Though

autonomy is accorded with so much value among medical workers, many discussions in biomedicalethics tend to put certain limits to its actual exercise on the part of a medical patient. There are sixenumerated general reasons or justifications where autonomy can be infringed or limited in the courseof medical treatment . These reasons are often called as liberty-limiting principles

1) A persons liberty is justifiably restricted to prevent that person from harming others. (the harmprinciple)

2) A persons liberty is justifiably restricted to present that person from offending others (the offenseprinciple)

3) A persons liberty is justifiably restricted to prevent that person from harming himself or herself (theprinciple of paternalism.

4) A persons liberty is justifiability restricted to benefit that person (principle of extreme paternalism)

5) A persons liberty is justifiably restricted to prevent that person from acting immorally (the principleof legal moralism)


2/4

6) A persons liberty is justifiably restricted to benefit others (social welfare principle)

2. Principle of Informed ConsentFrom the basic principle of autonomy comes the related and equally significant concept of informed

consent, which generally contains the elements of disclosure, understanding, voluntaries, competence,and permission giving.

It is the right and responsibility of every competent individual to advance his or her own welfare. Thisright and responsibility is exercised by freely and voluntarily consenting or refusing consent torecommended medical procedures, based on a sufficient knowledge of the benefits, burdens, and risksinvolved. The ability to give informed consent depends on:

1) Adequate disclosure of information;

2) Patient freedom of choice;

3) Patient comprehension of information; and

4) Patient capacity for decision-making .

While it is true that not all patients will take the information necessary for informed consent seriouslyas they should, those does not excuse, in a way, health care professional concerned to neglect this verycrucial principle in the physician-patient relationship.

3. Principle of Beneficencethe word Beneficence comes from the latin bene, which means good. Gen erally beneficence

means taking action to promote well-being of others. The principle of beneficence is a "middle principle"in so far as it is partially dependent for its content on how one defines the concepts of thegood and goodness. As a middle principle, beneficence is not a specific moral rule and cannot by itselftell us what concrete actions constitute doing well and avoiding evil.

4. Principle of Nonmaleficence

Closely akin to the principle of beneficence is the principle of nonmaleficence. While the formeradmonishes health care professionals to do good for their clients, the latter requires them to act insuch a manner as to avoid causing harm to the patients. is sometimes interpreted to imply that if onecannot do good without also causing harm, then one should not act at all (in that particularcircumstance)
http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=206&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=128&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=136&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=136&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=136&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=99&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=99&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=100&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=100&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=99&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=99&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=136&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=128&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=206&Itemid=172


3/4

Nonmaleficence refers to doing no harm; nonmalevolence refers to not intending or willing harm. Itmay be helpful to think of nonmaleficence not simply as "doing no harm," but as "doing no evil ," whichis closer to its etymological roots.

5. Principle of Justice

Simply speaking, justice has something to do with what is fair or what is deserved . The conceptof justice may be questioned when we attempt to decide who will be given an opportunity to participateand who (and for what reason) will be excluded.

Patients should not be selected due to class, socioeconomic status, or race unless justified bystudy objectives.

Women have been underrepresented in certain research studies because of the risks associatedwith child-bearing. Now researchers must justify why women are not included in a studypopulation. Failure to provide scientifically sound arguments for the exclusion of one gender, isgrounds for denial.

An existing physician-patient relationship requires consideration of the potential for power-based coercion when expanding that relationship to include investigator-subject. Provision, oradjustments, might need to be made to attempt to equalize the roles.

Physician-patient relationships always carry a perception of inequality in roles. The informedconsent process should reflect the precautions taken to balance the relationship and guardagainst even the perception of coercion.

6. Principle of Veracity (telling the truth)

This principle has something to do with telling the truth. The duty to tell the truth and othing but thetruth us a categorical imperative that is central and prominent in the ethical thought of the greatGerman philosopher Immanuel Kant. It is also agreed that yes, indeed, we all have the moral obligationto be truthful in our dealings with others, especially in the medical field.

Truth telling is considered a very important value among the patients that it is expressed and veryhighlighted in the statement on the Patients Bill of Rights (1975) Patients have the right to obtaincomplete information concerning diagnosis, treatment, and prognosis in terms they can be reasonablyexpected to understand

7. Principle of ConfidentialityA closely related to the Principle of Veracity is the Principle of Confidentiality. In the medical

context, confidentiality is the ethical principle that requires nondiscolusre of private or secretinforma tion with which on is entrusted.


4/4

8. Principle of Paternalism

Paternalism is widely defined as the interference with persons liberty of action justified by reasonsreferring exclusively to the welfare. Good, happiness, needs, interests, or value of the person beingcoerced. In this sense, negative connotations need not be attached to the concept. Paternalism in thecontext of healthcare is constituted by any action, decision, rule, or policy made by a physician or othercare-giver, or a government, that dictates what is best for the patient(s) without considering thepatients own beliefs and value system and does not respect patient autonomy.
http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=109&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=109&Itemid=172http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=109&Itemid=172

bioethical principles in healthcare

Documents