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Healthcare ethics isn't just abstract philosophy—it's the foundation for every clinical decision, patient interaction, and policy debate you'll encounter on your exam. You're being tested on your ability to recognize which principle applies in a given scenario, identify when principles conflict with each other, and articulate how providers should navigate those tensions. These principles show up in case studies, multiple-choice questions about patient rights, and FRQs asking you to analyze real-world healthcare dilemmas.
The ten core ethical principles fall into distinct categories: some protect patient rights and self-determination, others guide provider conduct and obligations, and still others address systemic fairness and resource allocation. Understanding these groupings helps you quickly identify the relevant principle when faced with a complex scenario. Don't just memorize definitions—know what each principle protects, when it might conflict with others, and how it shapes the provider-patient relationship.
These principles establish that patients are active participants in their care, not passive recipients. The underlying mechanism is respect for individual agency—recognizing that competent adults have the right to make decisions about their own bodies, even when those decisions conflict with medical recommendations.
Compare: Autonomy vs. Respect for Persons—both center on patient agency, but autonomy focuses specifically on decision-making capacity while respect for persons encompasses broader recognition of inherent human dignity. If an FRQ presents a patient who lacks decision-making capacity, respect for persons still applies even when autonomy is compromised.
These principles define what healthcare professionals owe their patients beyond technical competence. The core mechanism is fiduciary duty—providers hold specialized knowledge and power, creating an obligation to use that position for patient benefit rather than personal gain.
Compare: Beneficence vs. Non-maleficence—beneficence requires doing good while non-maleficence requires avoiding harm. In practice, most interventions involve both: chemotherapy harms healthy cells (non-maleficence concern) to destroy cancer (beneficence goal). Exam questions often test whether you can identify which principle dominates in a specific scenario.
These principles govern how information flows in the provider-patient relationship. The underlying mechanism is therapeutic alliance—effective healthcare depends on patients feeling safe enough to share sensitive information and trust the guidance they receive.
Compare: Confidentiality vs. Veracity—both involve information management but from opposite directions. Confidentiality restricts outward information flow (protecting patient secrets), while veracity requires inward information flow (ensuring patients receive truth). FRQs may present scenarios where these conflict—such as when family members request information the patient hasn't authorized sharing.
These principles extend beyond individual encounters to address how healthcare systems should function. The core mechanism is distributive ethics—recognizing that healthcare decisions affect not just the patient in front of you but the broader community competing for limited resources.
Compare: Justice vs. Dignity—justice addresses systemic fairness in resource allocation, while dignity focuses on interpersonal respect in individual encounters. A healthcare system could treat patients with dignity during visits while still maintaining unjust access barriers. Both principles are necessary for truly ethical healthcare.
| Concept Category | Key Principles | Core Question |
|---|---|---|
| Patient Self-Determination | Autonomy, Informed Consent, Respect for Persons | Who decides? |
| Active Provider Duties | Beneficence, Fidelity | What must providers do? |
| Harm Prevention | Non-maleficence | What must providers avoid? |
| Information Ethics | Confidentiality, Veracity | How should information flow? |
| Systemic Fairness | Justice | How should resources be distributed? |
| Human Worth | Dignity, Respect for Persons | How should patients be treated? |
| Trust Maintenance | Fidelity, Confidentiality, Veracity | What sustains the therapeutic relationship? |
A patient refuses a blood transfusion due to religious beliefs, even though it's medically necessary. Which two principles are in direct conflict, and which typically takes precedence for a competent adult?
Compare and contrast beneficence and non-maleficence. How might a single medical intervention involve considerations of both principles simultaneously?
A nurse discovers that a colleague has been accessing patient records without clinical justification. Which ethical principle has been violated, and what broader harm does this cause beyond the individual privacy breach?
An emergency department has one available ICU bed and two critically ill patients who need it. Which ethical principle primarily guides this decision, and what factors should—and should not—influence the choice?
A physician believes a patient would be emotionally devastated by a terminal diagnosis and considers withholding the information. Identify the ethical principles in tension and explain how informed consent relates to this dilemma.