Bioethical Principles
The significance of principles in bioethics
Ethical decisions, both minor and major, confront us daily when providing health care to people with diverse values in a pluralistic and multicultural society. Where can we find moral action guides in the face of such diversity when there is confusion or conflict about what should be done? Such guidelines must be broadly acceptable among religious and non-religious people and people from many different cultures. Because of the many variables that exist in clinical cases and the fact that several ethical principles appear to be applicable in many situations in health care, these principles are not considered absolutes.
However, they serve as powerful action guides in clinical medicine. Some medical ethics principles have been in use for centuries. Hippocrates, a physician-philosopher, directed physicians “to help and do no harm” in the fourth century BCE (Epidemics, 1780).
Similarly, considerations of respect for persons and justice have been present in the evolution of societies since the beginning.
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However, in 1979, Tom Beauchamp and James Childress published the first edition of Principles of Biomedical Ethics, which is now in its seventh edition (2013), popularizing the use of principlism in efforts to resolve ethical issues in clinical medicine. In the same year, the Belmont Report identified three principles of respect for persons, beneficence, and justice as guidelines for responsible research involving human subjects (1979). Thus, it is widely accepted in both clinical medicine and scientific research that these principles can be applied, even in unusual circumstances, to guide us in determining our moral obligations in that situation.
