Bioethical principles (definition, examples, in healthcare, in nursing, in research) are based on the evidence of medicine and bioethics and how they are implemented for clinicians, organizations, and patients.
It has been observed that since the beginning of the 1990s, the enthusiasm for evidence-based medicine has increased. As its methodology is becoming more sophisticated and its breath expands, bioethical principles refer to medical education, patient care, health care policymaking, and technology assessments.
Despite the fast growth, the intersection of evidence-based medicine (EBM) and bioethics has not been explored to the extent to which it should reach.
This article will be covering different bioethical principles along with assessing the utilitarian and deontological aspects of the EBM. People with strong ethical arguments support EBM as the best approach for patient care but the health organizations and practitioners must be aware that each principle involved in these complex issues will be challenging EBM’s ethical values.
The four major principles of bioethical processing were originally developed by James Childress and Thomas Beauchamp and now these principles are used in modern bioethical decision making and debate to explain different challenges for achieving premier status in bioethics.
The four principles that form the basis of modern bioethics include beneficence, autonomy, no maleficence, and justice.
The originator of these principles claims that all four are of equal importance and challenges have been laid against these principles as well and some disagreements have been observed in history. This writing will look at the nature of the most important of these challenges.
These four principles have been facing challenges now for nearly 30 years and still, they are used as valid points for most decision making in both clinical practice and research settings within the chiropractic profession. But the professional understanding of the principles is under process and it provides a fertile area for further investigation.
Definition: Bioethical Principles
The Bioethics principle is defined as the discipline dealing with ethical implications of the biological applications and research that are available in medicine. It covers the study of what is wrong and right in new techniques and discoveries in biologies such as transplantation of organs, genetic engineering, and more.
Along with the two above-mentioned authors, the book named “Principles of Bioethics” also includes other authors. Ethical choices whether they are major or minor confront us every day in the case of health care for persons that are filled with diverse values living in a multicultural and pluralistic society. In such a diverse society, where our moral actions can guide us when there is conflict and confusion about what ought to be done?
The mentioned guidelines need to be broadly acceptable among nonreligious and religious persons of a different cultures.
Due to the variability existing in the context of the clinical cases along with surrounding the fact that as far as health care is considered several ethical principles are existing all around that seem to be applicable in different situations however, these principles are not considered absolute but they serve as powerful actions guide in clinical medicine and some of these principles have been in use for centuries.
One of the examples of the above-mentioned explanation is that Hippocrates who was a physician-philosopher of the 4th century BCE directed physicians that they should help patients without any harm.
Similarly, consideration for justice and respect for persons presented in the development of societies from the earliest times however with regards to the decision of ethical processing in medicine, Tom Beauchamp and James Childress published the first edition of Principles of Biomedical ethics in 1979.
Moreover, its seventh edition came out in 2013 popularizing the use of principles making efforts for resolving ethical issues in clinical medicine, and in the same year, three further principles of beneficence, persons, and justice were identified as guidelines responsible for research using human subjects in the Belmont Report (1979).
Thus in scientific research and clinical medicine, it is generally held that these above-mentioned principles can be applied even in strange circumstances for guiding in discovering the moral duties within the different situations.
The next thing you should know is how to apply the principles in certain cases such as health care? As we have begun with health care we will have a look at it first. The principles that are in the current usage of health care seem to be self-confident holding a clear application.
For example, the notion that is accepted by a different physician that ought not to harm any patient convinces most of them. Or the second idea that physicians should look for adopting a care plan for the benefit of patients in terms of competing alternatives seems to be rational and self-evident.
And now with further advancement, a new practice has been adopted that before the implementation of any plan individuals but be allowed to choose/her care, and subsequently medical benefits should be dispensed fairly so that people with similar circumstances and needs should be treated with equality, an important concept in the light of resources such as bone marrow, expensive diagnostics, medications, procedures, and other expensive solid organs.
One might argue that we should adopt all the above-mentioned principles to apply them to all clinical cases under consideration yet when these two or more principles are applied we find that we are standing in the center of a conflict.
For instance, being a doctor you have diagnosed that a patient is suffering from an acutely infected appendix and your medical goal should be to provide great benefits to the patient, maybe an indication for immediate surgery.
But some responsibilities rest on your shoulders as well while giving anesthesia and doing surgery a small risk is involved that the patient may not lose his life. The rational calculus has shown that a patient is at a higher danger of being infected from a ruptured appendix if we do not work than from surgical procedure and anesthesia if we fasten the process of surgery.
The language of ethics relates to healthcare to a major extent and being related to healthcare it is commonly called bioethics and applied across all practice settings and it also includes the same principle that is mentioned above. For case managers, fidelity and veracity are taken as ethical principles but they are not considered a part of fundamental ethical principles identified by bioethicists.
The principle of great autonomy has spread like branches of a tree in healthcare. It is defined as the ability to make decisions for oneself also titled self-government. We have great respect for equating freedom and individual right with autonomy.
Our democratic system of law supports autonomy such as upholding the right of individuals for making decisions about their healthcare.
Respect for autonomy requires that it is the right of the patient to know about his true condition and be informed about the risks and the benefits of treatment to make informed decisions.
Law has given them the right to refuse treatment even if they are provided with the best and most beneficial treatment unless the actions are indicating a negative impact on the well-being of the individuals.
The concept of autonomy has developed from paternalistic physicians held for decision-making to empower the patients to participate in deciding for their care. Autonomy does not negate responsibility and it defines healthcare as a partnership between the provider and the recipient of care.
Bioethical principles involve big moral picture dilemmas that are faced by the medical community. In nursing, the ethics relates to the situation created between a care provider and a patient and wrestles with some questions that are given as
- Who is worthwhile?
- What is the fitting response to the moral dilemma mentioned in writing?
- On what moral grounds claims can be made?
- What are our obligations towards others?
- What is the right thing to do?
The principles of bioethics underline the practice of informed consent and the informed consent of a patient occurs when a patient receives education about the benefits, risks, and alternatives to treatments.
The fundamentals principles of bioethical principles should be considered while making a research project. The word ethic is derived from the Greek word ethos holding the meaning of custom or character.
Ethics means understanding the nature of conflict arising and how we can deal with them in a better way. It deals with the choices and decisions made by clinicians and patients and the obligations and duties of clinicians towards their patients.
History is unfortunately filled with the stories of abuse that were carried out in the name of medical research and one of the deadly atrocities that are mentioned in history is about Nazi doctors who made the use of convicts for human experiments.
The principles laid by Childress and Beauchamp have shown great influence in the field of medical ethics and they serve the goal of understanding the current approach to ethical assessments in health care. In the present context, the word research covers the medical and behavioral studies concerned with human health, and the modification of the word biomedical relates it to health.
All these explanations of bioethical principles in research, nursing, and health care will be providing a better clarification to the readers.
External resource: Wikipedia