Bioethical Principles in Healthcare

1. Principle in Autonomy
One of the most important principles in bioethical sphere, particularly in medical ethics, is the concept of autonomy. The term autonomy comes from the greek autos (self) and nomous (governance). In the context of health care, the principle of autonomy specifically applies to respect for the patients autonomy. Health care providers should view and treat every patient as an independent, self-governing as well as self-determining being. These are the following specific actions that medical prefessionals can do in accordance with the principle in dealing with their patients. 1) Obtaining informed consent for treatment. 2) Facilitating patient choice regarding treatment options 3) Allowing the patient t refuse treatment 4) Disclosure by the provider of personal medical information, diagnoses, and treatment options to the involved patients/. 5) Maintaining confidentiality. The basic right to self-determination is said to put a clear boundary with regards to what physicians, nurses, and other health care professionals can justifiably do to patients under their care. Though autonomy is accorded with so much value among medical workers, many discussions in biomedical ethics tend to put certain limits to its actual exercise on the part of a medical patient. There are six enumerated general reasons or justifications where autonomy can be infringed or limited in the course of medical treatment. These reasons are often called as liberty-limiting principles 1) A persons liberty is justifiably restricted to prevent that person from harming others. (the harm principle) 2) A persons liberty is justifiably restricted to present that person from offending others (the offense principle) 3) A persons liberty is justifiably restricted to prevent that person from harming himself or herself (the principle of paternalism. 4) A persons liberty is justifiability restricted to benefit that person (principle of extreme paternalism) 5) A persons liberty is justifiably restricted to prevent that person from acting immorally (the principle of legal moralism)

6) A persons liberty is justifiably restricted to benefit others (social welfare principle)

2. Principle of Informed Consent

From the basic principle of autonomy comes the related and equally significant concept of informed consent, which generally contains the elements of disclosure, understanding, voluntaries, competence, and permission giving. It is the right and responsibility of every competent individual to advance his or her own welfare. This right and responsibility is exercised by freely and voluntarily consenting or refusing consent to recommended medical procedures, based on a sufficient knowledge of the benefits, burdens, and risks involved. The ability to give informed consent depends on: 1) Adequate disclosure of information; 2) Patient freedom of choice; 3) Patient comprehension of information; and 4) Patient capacity for decision-making. While it is true that not all patients will take the information necessary for informed consent seriously as they should, those does not excuse, in a way, health care professional concerned to neglect this very crucial principle in the physician-patient relationship.

3. Principle of Beneficence
the word Beneficence comes from the latin bene, which means good. Generally beneficence means taking action to promote well-being of others. The principle of beneficence is a "middle principle" in so far as it is partially dependent for its content on how one defines the concepts of the good and goodness. As a middle principle, beneficence is not a specific moral rule and cannot by itself tell us what concrete actions constitute doing well and avoiding evil.

4. Principle of Nonmaleficence
Closely akin to the principle of beneficence is the principle of nonmaleficence. While the former admonishes health care professionals to do good for their clients, the latter requires them to act in such a manner as to avoid causing harm to the patients. is sometimes interpreted to imply that if one cannot do good without also causing harm, then one should not act at all (in that particular circumstance)

Nonmaleficence refers to doing no harm; nonmalevolence refers to not intending or willing harm. It may be helpful to think of nonmaleficence not simply as "doing no harm," but as "doing no evil," which is closer to its etymological roots.

5. Principle of Justice
Simply speaking, justice has something to do with what is fair or what is deserved . The concept of justice may be questioned when we attempt to decide who will be given an opportunity to participate and who (and for what reason) will be excluded.

Patients should not be selected due to class, socioeconomic status, or race unless justified by study objectives. Women have been underrepresented in certain research studies because of the risks associated with child-bearing. Now researchers must justify why women are not included in a study population. Failure to provide scientifically sound arguments for the exclusion of one gender, is grounds for denial. An existing physician-patient relationship requires consideration of the potential for powerbased coercion when expanding that relationship to include investigator-subject. Provision, or adjustments, might need to be made to attempt to equalize the roles. Physician-patient relationships always carry a perception of inequality in roles. The informed consent process should reflect the precautions taken to balance the relationship and guard against even the perception of coercion.

6. Principle of Veracity (telling the truth)

This principle has something to do with telling the truth. The duty to tell the truth and othing but the truth us a categorical imperative that is central and prominent in the ethical thought of the great German philosopher Immanuel Kant. It is also agreed that yes, indeed, we all have the moral obligation to be truthful in our dealings with others, especially in the medical field. Truth telling is considered a very important value among the patients that it is expressed and very highlighted in the statement on the Patients Bill of Rights (1975) Patients have the right to obtain complete information concerning diagnosis, treatment, and prognosis in terms they can be reasonably expected to understand

7. Principle of Confidentiality
A closely related to the Principle of Veracity is the Principle of Confidentiality. In the medical context, confidentiality is the ethical principle that requires nondiscolusre of private or secret information with which on is entrusted.

8. Principle of Paternalism
Paternalism is widely defined as the interference with persons liberty of action justified by reasons referring exclusively to the welfare. Good, happiness, needs, interests, or value of the person being coerced. In this sense, negative connotations need not be attached to the concept. Paternalism in the context of healthcare is constituted by any action, decision, rule, or policy made by a physician or other care-giver, or a government, that dictates what is best for the patient(s) without considering the patients own beliefs and value system and does not respect patient autonomy.