Medical Ethics - Principlism

The philosophy of Principlism argues that any medical ethical dilemma can be reduced to these four basic principles. In any situation one or two principles are likely to take precedence over the others:

Beneficence

• doctors should only do good to their patients

Non-maleficence

• doctors should do no harm to their patients

Autonomy

• patients should have self-determination over their decisions. A fully autonomous decision should be informed, competent and not made under coercion

Justice

• scarce healthcare resources should be shared fairly (whatever that means)

Principlism has been widely taught over the last 30 years (most of us will have heard of it at Medical School!), and it is still a useful approach to most ethical problems, although it does have its critics.

In our current Western society, autonomy is being seen as being increasingly important with the basic human rights of the individual being emphasised and delineated ever more clearly. The emphasis on social justice (very important in the post-war years) seems to be on the wane.

Written by: Martyn Hewett

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Written by: Michael Harris

Last updated: 16 September 2006