![]() ![]() ![]() This is further complicated by the fact that the construction of a unified theory of justice that captures our diverse conceptions and use of principles of justice in biomedical ethics remains controversial and hard to pin down.īiomedical ethics and evidence-based medicine Įvidence-based medicine (EBM) - the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients - can sometimes be challenged by one or more of the principles of biomedical ethics. Countries that lack a comprehensive and coherent healthcare system typically have larger numbers of unprotected citizens and therefore need to improve both utility (efficiency) and justice (fairness and equality). No single moral principle is capable of addressing all problems of justice and no single theory of justice or system of distributing healthcare is sufficient for constructive reflection on health policy. ![]() Patient welfare embodies medicine's goal, justification and rationale - examples here include public health, preventative medicine and biomedical research. The principles of beneficence potentially require more than those of nonmaleficence, because doctors must take positive steps to help people and not merely refrain from harm. These beneficial actions fall under the heading 'beneficence'. It must be remembered that the principle of nonmaleficence and its specifications in moral rules are prima facie and not absolute.įrom an ethical viewpoint, morality requires that we not only treat patients autonomously and refrain from harming them, but that we also contribute to their welfare. The obligations of nonmaleficence include not only obligations not to inflict harm, but also not to impose risks of harm. Do not deprive others of the goods of life.The principle of nonmaleficence obligates us to abstain from causing harm to others.The principles of nonmaleficence support several moral rules, with examples here including: Respect for autonomy is not a mere ideal in healthcare - it is a professional obligation. It must never be assumed that because a patient is part of a particular culture or community, they affirm that community's values and beliefs. Health professionals should enquire about their patient's wishes to receive information and to make decisions. It is based on four key principles first propounded in 1979 by Beauchamp and Childress in their book Principles of Biomedical Ethics. This is an attempt to cover some of the aspects that are more pertinent to general practice.īiomedical ethics is a huge subject in its own right. Much has been written about medical ethics and it would be impossible to cover everything here. In the UK, the principles enshrined in Good Medical Practice - the handbook of the General Medical Council (GMC) - are a good place to start. Every clinician must keep up-to-date on current legislation and ensure that they are practising within the law and within the guidelines laid down by their professional body. Euthanasia, information sharing and the use of human tissues are typical examples. Medical and social ethics have advanced to an extent that doctors are likely to be faced with controversial issues on a regular basis. Follow such a tenet blindly and you could well find yourself on the wrong side of the law. It is no longer enough simply to treat the patient as you would wish to be treated yourself. To maintain confidentiality and never to gossip.'.Not to harm, especially not to seduce patients.Of beneficence (to do good or avoid evil) and non-maleficence (from the Latin 'primum non nocere', or 'do no harm') towards patients.Of solidarity with teachers and other physicians.Ideals and the Hippocratic Oath have been covered in a separate article but it is worth repeating the summary of the Oath here: 2.Ethics involves the application of a moral code to the practice of medicine.Doctors have to appreciate and negotiate these contending interests so that the patient sees the primary of the health interest vis a vis others.In secondary and tertiary care, health problems can be urgent and overwhelming that patient interests shrunk to coincide with his health interests.What does it mean in practice “to act for the good of patients”?.Hippocratic Oath, “ I will prescribe regimen for the good of my patients according to my ability and judgment and never do no harm to anyone”.GMC 2001 “Make The Care Of Your Patient Your First Concern” Beneficence is central to most code of professional ethics e.g. ![]()
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