Bioethics and Moral Theories in Healthcare

Five Bioethical Principles

• Autonomy: A person's rational capacity for self-governance or self-determination; the ability to direct one's own life.
• Nonmaleficence: Not to intentionally harm others.
• Beneficence: To constitute the very soul of morality (doing good to others).
• Utility: This principle says that we should produce the most favorable balance of good over bad for all concerned.
• Justice: People getting what is fair or what is their due.

Six Key Moral Theories

• Utilitarianism: A consequentialist moral theory that insists the rightness of actions depends solely on their consequences or results.
• Kantianism/Deontology: Kant's principle of respect for persons says that we should always treat persons never merely as a means to an end; i.e., don't use people.
• Natural Law: Right actions are those that conform to moral standards discerned in nature through human reason.
• Contractarianism: As members of a society, we have duties to others, who have rights to basic liberties.
• Virtue Ethics: The goal is to develop a virtuous disposition, from which virtuous acts emanate.
• Ethics of Care: The heart of the moral life is feeling for and caring for those with whom you have a special relationship.

Patient and Physician Autonomy (Chapters 3 and 4)

• Patient Autonomy: Patients should be able to make their own healthcare choices, to exercise their capacity for self-determination, unless there are very good reasons for not allowing them to do so.
• Physician Autonomy: The freedom of doctors to determine the conditions they work in and the care they give to patients.
• Weak Paternalism: Paternalism directed at persons who cannot act autonomously or whose autonomy is greatly diminished.
• Strong Paternalism: The overriding of a person's actions or choices even though he is substantially autonomous.
• Confidentiality: Concerns a healthcare provider’s obligation to protect a patient’s privacy.
• Hippocratic Oath: Has provided for centuries the codes of medical practice and ethics for Western medicine.

Informed Consent and Competence (Chapter 5)

• Competence: The ability to render decisions about medical interventions.
• Informed Consent: The action of an autonomous, informed person agreeing to submit to medical treatment or experimentation.
• Therapeutic Privilege: The withholding of relevant information from a patient when the physician believes disclosure would likely do harm.
• Waiver: The patient’s voluntary and deliberate giving up of the right to informed consent.