The basic four premises of ethical delivery of care are Autonomy, Justice, Beneficence, and nonmaleficence. However, does this refer to the caregiver or to the patient? What happens when there is conflict and then who trumps who or how can resolution be reached?
These four principles of biomedical ethics guide medical practitioners to make decisions at the time of the ethical dilemma involving patient’s treatment. This can be explained by taking a scenario when a nurse is asked by a patient’s family to keep information of patient’s poor prognosis with an incurable disease from the patient himself. In this situation, the principle of autonomy explains the rights of the patient to have control over his body. A medical practitioner can only suggest him but cannot take any action forcefully or persuade the patient as it violates the principle. (Page, 2012)
While the principle of beneficence refers to the treatment of patient in a way that the patient is benefitted in every situation. Similarly, non-maleficence explains not to cause or do any harm to the patient. These two often go simultaneously, however there may be situation when they override. In such situations, medical practitioners hide the information regarding the poor prognosis to save patient from mental trauma through beneficence. This violates the principle of autonomy to allow patient to make his own decision by knowing the truth and even the principle of justice which means having the right to receive full information about the disease prognosis and that too passed to his family without his consent (Aldcroft, 2012). If the patient accidently discovers the truth it may lead to mental trauma which might be more fatal than the disease.
In conclusion we can say that, there cannot be a single principle to this situation. The ethical principles can guide the medical practitioners to make a decision by analyzing the situation to attain maximum beneficence and minimum harm.
Aldcroft, A. (2012). Measuring the Four Principles of Beauchamp and Childress. Retrieved 12 5, 2017, from https://blogs.biomedcentral.com/bmcseriesblog/2012/07/13/measuring-the-four-principles-of-beauchamp-and-childress/
Page, K. (2012). The four principles: Can they be measured and do they predict ethical decision making. BMC Med Ethics.