Ethical Choices In Healthcare

Ethical choices, both minor and major, confront us every day in the delivery of health care for persons with diverse values living in a varied and multicultural society. In the face of such diversity, healthcare providers must find moral action guides when there is confusion or conflict about what ought to be done. Such guidelines need to be broadly acceptable among the religious and the nonreligious and for persons across many different cultures. Due to the many variables that exist in the context of clinical cases as well as the fact that in health care there are several ethical principles that seem to be applicable in many situations these principles are not considered absolutes, but serve as powerful action guides in clinical medicine.

For example, in the 4th century BCE, Hippocrates, a physician-philosopher, directed physicians “to help and do no harm” (Epidemics, 1780). Similarly, considerations of respect for persons and for justice have been present in the development of societies from the earliest times. However, specifically in regard to ethical decisions in medicine, in 1979 Tom Beauchamp and James Childress published the first edition of Principles of Biomedical Ethics, now in its seventh edition (2013), popularizing the use of principlism in efforts to resolve ethical issues in clinical medicine. At the core of principlism is the idea that ethical justification rests primarily, if not exclusively, in applications to more general or "higher level" moral norms under which any more particular ethical claim can be incorporated. In that same year, three principles of respect for persons, beneficence, and justice were identified as guidelines for responsible research using human subjects in the Belmont Report