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BIOETHICAL PRINCIPLES Beauchamp and Childress 2001;Gillon 1986 • Bioethical Principles • standard approach to biomedical ethics • endorsed by most moral theories • provide a framework that may facilitate resolution of ethical problems • four key principles: autonomy (respect for autonomy), non-maleficence, beneficence, justice • each principle needs to be weighed and balanced in determining an optimal course of action BIOETHICAL PRINCIPLES Beauchamp and Childress 2001;Gillon 1986 • Autonomy – principle of self-rule • right to participate in and decide on a course of action; freedom to act independently • competent adult’s informed decision to refuse (even life-saving) treatment supercedes offer of treatment medical paternalism - acting without consent or overriding a person’s wishes, wants, or actions, in order to benefit the patient or prevent harm strong paternalism, the overriding a competent patent’s wishes weak paternalism, acting for the benefit of an incompetent patient BIOETHICAL PRINCIPLES Beauchamp and Childress 2001;Gillon 1986 • Non-maleficence - principle of avoiding harm to the patient • justification for ‘acts and omissions’ distinction in law (withholding/withdrawing treatment that is not benefiting patient) BIOETHICAL PRINCIPLES Beauchamp and Childress 2001;Gillon 1986 • Beneficence – principle of doing what is best for the patient • promotion of patient’s best interests • prevent or remove harm • encompasses sanctity of life principle • when in conflict, non-maleficence supersedes the principle of beneficence. BIOETHICAL PRINCIPLES Beauchamp and Childress 2001;Gillon 1986 • Justice - principle based on fairness, equity and equality • treat similar cases in similar ways • distribute health care resources (goods and service) fairly • proper distribution of benefits and burdens