Ethics in Medicine: How Bioethics Builds a Framework for Providing Care Part 1

Share with your network

Part 1: The Foundation of Ethics in Healthcare

Determining ethical standards is a priority in any field that involves choices, experimentation, and human interaction. The healthcare industry is no exception. Medical staff aim to establish standards that encourage humane, morally-sound patient care and research. Implementing a system of ethics, or moral principles that determine what is right and wrong, is one way to regulate medical practices. However, creating one consistent ethical code across national healthcare is difficult, given that beliefs often differ across societies and cultures. So how does one determine the role of ethics in the healthcare field?

Bioethics refers to the ethics involved in medical and biological research and is often applied to healthcare settings as well. These are commonly used to guide professionals when they must make choices that cross into potentially subjective territory. Below, we explain the basics of bioethics and how they can be applied in healthcare settings.

Principles of Medical Ethics

Though bioethics researchers differ on the exact ethical standards healthcare professionals should follow, four principles from Thomas Beauchamp and James Childress explain common understandings of bioethics: respect for autonomy, non-maleficence, beneficence, and justice.

Respect for autonomy refers to the idea that a patient has the right to control their own body and the ability to make informed, voluntary decisions. This means that a patient’s decisions should be respected so long as they are able to think freely. For example, if individuals that follow certain religions refuse to undergo procedures like blood transfusions, this principle argues that their wishes should be respected given the assumption that they are rational individuals.

Nonmaleficence means that healthcare providers cannot intentionally harm a patient and any potential danger must be minimized as much as possible. In situations where harm is inevitable, it is the responsibility of the professional to choose the option that causes the least injury. This principle ties in with respect for autonomy when a patient makes the decision to abstain from life-saving treatment if the treatment would cause too much suffering or pain.

Beneficence states that medical staff members serve as a benefit to patients and are tasked with preventing the patient from experiencing harm. This principle differs from nonmaleficence in that although providers should never directly harm anyone, they can choose the patients they wish to benefit through permitting specific individuals into their practices or prioritizing the care of one over another. At times, beneficence can take precedence over respect for autonomy in situations when the patient cannot think independently, and medical providers must make the decision to help them without their consent.

The fourth principle, justice, asserts that individuals are equal and should be treated as such. This means that quality medical care and resources should be distributed evenly so that a certain demographic is not deprived of medical assistance and treatment. It also refers to the responsibility of healthcare professionals to adhere to legislation in their decisions. However, it can be argued that the principle of justice is not always applied in healthcare, as individuals who are of lower socioeconomic status or identify with minority races may receive unequal treatment.

The Hippocratic Oath

Another source medical practitioners use as a basis for ethics is the Hippocratic Oath. Originating from Ancient Greece, the oath emphasizes for those who swear by it to uphold ethical standards, including the popularized phrase to “first do no harm.” While many adaptations have been made, the 1964 version rewritten by Tufts University Academic Dean Louis Lasagna is used in many medical schools today. In this version, individuals swear to respect privacy, prevent disease, protect the environment, and view patients as human beings, among other criteria. The Hippocratic Oath remains a reminder in the medical community to uphold high standards of patient care and practice medicine ethically.

The study and practice of bioethics through its main principles of autonomy, non-maleficence, beneficence, and justice have improved the standards and quality of healthcare in all settings. In the next part of this Ethics in Healthcare series, we will explore how ethical issues in healthcare often arise when there is a conflict between the four principles.