The four principles of Beauchamp and Childress – autonomy, nonmaleficence, beneficence, and justice – have significantly impacted medical ethics and are critical to understanding the current approach to ethical assessment in health care. This study investigates whether these principles can be quantitatively measured individually and whether they are used in decision-making when individuals face ethical quandaries.
The Analytic Hierarchy Process was used as a measurement tool for the principles. Four scenarios involving conflicts between medical ethical principles were presented to participants, who then made judgments about the ethicality of the action in the scenario and their intentions to act similarly if they were in the situation.
The Analytic Hierarchy Process can assess individual preferences for these medical ethical principles. This technique is a valuable tool for emphasizing individual medical ethical values. Individuals have a significant preference for nonmaleficence over the other principles on average; however, perhaps counter-intuitively, this preference does not appear to be related to applied ethical judgments in specific ethical quandaries.
People claim to value these medical ethical principles, but they do not appear to apply them directly in decision-making. The reasons for this are the lack of a behavioral model to account for the relevant situational factors that the principles do not capture. The principles’ limitations in predicting ethical decision-making are discussed.
