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PRINCIPLES OF BIOMEDICAL ETHICS

I.

Four Principles of Medical Ethics

a.

Respect for Autonomy/Persons

i.

Respect for Autonomy

1.

Self rule, self determination, self governance

2.

Liberty rights, individual choice, freedom of will

3.

Free from controlling interference of others

4.

Free from limitations (ie inadequate information)

5.

Having a self chosen plans

ii.

Respect for Persons

1.

Recognizing inherent dignity of person

2.

Recognizing unconditional value in persons

3.

Both through belief and behavior

4.

Applied equally to all

5.

Often defined in the eye of the beholder

6.

Results in better health outcomes

iii.

Application in Medical Context

1.

Does not apply to those who can’t act autonomously

2.

Non-interference

3.

Enabling relationships that embody respect for indvl

4.

Positive assistance with individual choices

5.

Truthtelling: communicating with patient in a culturally sensitive manner

a.

Patients have the right to accept/decline info

6.

Confidentiality: respecting and individual’s privacy

7.

Informed Consent: allowing the patient to make an informed decision about his medical care

iv.

Limits of Autonomy

1.

Some choices are made without rational mindset

2.

Problem of authenticity: the bull looks different once you step into the ring

3.

Fails to consider interests of collective body

4.

No non-arbitrary way to define which choices are purely self regarding

b.

Non Maleficence

i.

Obligation not to harm may be more stringent than obligation to help

ii.

Intentionally refraining from actions that cause harm

1.

Kill, cause pain/suffering, incapacitate, offend, deprive others of good of life

2.

Negligence: absence of due care—intentional or unintentional—not following professional standards of care

c.

Beneficence

i.

Acting in the best interest of an individual

ii.

Utility: proportional balance benefits and drawbacks

iii.

Patient’s good:

1.

Medical good

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