The Four Principles of Health Care Ethics: Non-Maleficence, Beneficence, Autonomy, Justice

How the 4 Principles of Health Care Ethics Improve Patient Care

Working in the health care industry is equally gratifying and challenging for any health care professional. Each day is filled with choices that have positive and negative consequences. The four principles of health care ethics were created to support professionals as they navigate patient care. These principles are autonomy, beneficence, non-maleficence, and justice. 

Each of these principles has a unique objective, but the four come together to ensure that patients are receiving high quality and ethical health care.

#1 – Autonomy

The Four Principles of Health Care Ethics - Autonomy: Respect a person's freedom to choose what's right for them

The literal meaning of autonomy and the medical definition of autonomy are different yet almost the same. Autonomy is the control that you exercise when making individual decisions, especially regarding your well-being. In health care, autonomy is the right or freedom of the patient to maintain control of their body before and after treatment.

The practice of autonomy denies professionals in health care the opportunity to potentially coerce or persuade the patient to take a specific action or treatment plan. Ideally, autonomy targets patient welfare by allowing the patient, especially when conscious, to be in full command of their treatment and care. 

This principle is vital in the delivery of evidence-based care because not all medical professionals agree with certain treatment options and medication processes. As such, this principle addresses the clause of the best treatment option that the health care provider made independently. Nurses should not influence a patient’s decision; however, it is their responsibility to ensure that patients are educated and informed. 

In autonomy, patients and caregivers have contrasting beliefs, customs, and ideas. This means that the best course of action for one could be detrimental for another patient, even if they share the same signs and symptoms.

Autonomy fosters self-respect, self-knowledge, and self-worth.

#2 – Beneficence

The Four Principles of Health Care Ethics - Beneficence: All choices for a patient are made with the intent to do good

Beneficence is the act of showing kindness or mercy. The actions of any health care provider should always bring positivity. Beneficence should not be confused with the closely related ethical principle of nonmaleficence, which states that one should not do harm to patients. This principle acts as an obligation for nurses to protect their patients from harm by removing and preventing bad situations and promoting good ones.

Beneficence is an essential principle of health care ethics and ethical selfishness. The principle states that health care workers must invest time and effort to ensure that the patient benefits in each situation. Most individuals choose health care as a profession because they want to help other people. 

The difficulty with this principle often lies in defining what good means to the patient. Before acting with beneficence in mind, nurses must consider the patient’s wants and needs. 

#3 – Non-Maleficence

The Four Principles of Health Care Ethics - Non-Maleficence: Do no harm

This is the most prioritized of the four ethics. Non-maleficence means that health care workers must do no harm intentionally. According to the ANA code of ethics, all health care workers should carefully evaluate their situations before making decisions. Whether knowingly or unknowingly, some decisions can cause harm to patients, the community, or even other health care workers.

Non-maleficence covers four factors. First, an act should not be truly wrong. Also, every action should have a positive benefit. Thirdly, a good effect should never be a result of the wrong action. Lastly, good outcomes should always outweigh the bad. 

Here is an example: A patient comes in with a health complication that has several solutions; different prescription drugs option. A physician selects a drug that has possible allergic effects without informing the patient. Later, the patient suffers from adverse drug effects.

Such a case is considered maleficence because the physician had other better options. More so, all health care workers have to communicate with the patient regarding all treatment procedures.

The goal of health care workers is to save the life of the patient by all means possible. Another example of non-maleficence is a case where a patient needs surgical treatment. Though surgeons use anesthetics during surgery, a patient feels pain after the surgery. However, surgery practice is not maleficence because it is the only solution to saving the life of the patient.

Keep in mind that the non-maleficence principle does not only apply to patients but also colleagues. Every health care provider should provide a comfortable working environment for other employees. Actions intended to harm other employees are considered maleficence.

Even verbal abuse at work is treated as maleficence. The non-maleficence principle was invented to protect health care workers and patients. 

#4 – Justice

The Four Principles of Health Care Ethics - Justice: Treat and provide care fairly to all patients

The justice principle states that there should be fairness in all medical decisions. For instance, patients deserve advanced health care delivery regardless of their situation. There have been numerous cases where patients fail to get the necessary treatment due to economic status, ethnicity, sexual orientation, etc.

Following the ANA code of ethics, the top priority of all health care workers should be saving the lives of all patients. For example, say a patient walks in the hospital, needing emergency treatment. During the evaluation of patient situations and processing of documents, the health care staff realize that the patient is an undocumented immigrant. A competent health care worker would proceed with the emergency treatment first, then begin questioning the patient when he or she is stable.

Health care workers should listen to the interests of all patients before beginning medical procedures. For instance, if there are alternative treatments, a patient deserves to know and assist in making a strong decision. For individuals under the age of 18, their parents or guardians should approve the intended medical choices.

A current debate revolves around reproductive health technologies. Justice would call for equitable access to reproductive health services for all women. 

Justice does not only apply to patients but also health care providers. All physicians, nurses, and other health experts have a right to practice their profession in a pleasant environment. Also, all health care professionals deserve equal chances of assisting in the decision-making process. 

Health care professionals must hold strong to a solid moral compass. That’s why we only take the best nurses and healthcare professionals at Clipboard Health. Holding yourself to a high ethical standard will benefit the trust present between you and your patient. When ethical dilemmas arise, health care workers must consider the four principles of health care ethics when formatting the best response.