Ethical Principles, Values, and Decision-Making in Healthcare

  • Describe four principles and how they nest.
  • Principle of Autonomy: The right of everyone to decide for themselves on all matters that affect them in any way, knowingly and without coercion of any kind. This determines the duty of each to respect the autonomy of others.
  • Principle of Beneficence: The right to live according to one’s own conception of life, ideals, and happiness. Related to the principle of autonomy, this also determines the duty of everyone to seek the good of others, not in their own way of understanding, but rather as a function of the other’s self-seeking.
  • Principle of Nonmaleficence: The right not to be discriminated against based on biological considerations such as race, sex, age, or health status. This also determines the duty not to cause harm, even if requested.
  • Principle of Justice: The right not to be discriminated against based on cultural, ideological, political, social, or economic factors. This determines the duty to respect diversity and work towards an equitable distribution of benefits and risks among members of society. Nesting of Principles: In case of conflict between principles, priority must be given to those that result in the best, or least bad, consequences from a moral point of view. The principles of nonmaleficence and justice take precedence; they are public, relate to our relationship with the outside world, and determine our duties to all human beings. They are therefore required for all. Autonomy and beneficence belong to the private sphere of each person, as they respond to the development of their life project.

Factors Influencing Individual Decisions

  • Individual Values: The activities, experiences, and knowledge of individuals and their culture will help determine what is right or wrong.
  • Behavior and Values of Others: Good or bad influences from important people, such as parents, friends, and colleagues, will guide their behavior when making a decision.
  • Official Code of Ethics: An ethical code guides ethical behavior; without one, individuals could make unethical decisions.

Principles and Values in the Profession

  • Honesty: Acknowledge your weaknesses and limitations, seeking advice from more experienced colleagues when necessary.
  • Respect: Show respect for human dignity and the right to self-determination.
  • Commitment: Keep your promises and fulfill your obligations. Do not justify breaches of commitments or shirk responsibility.
  • Loyalty: Act honestly and sincerely, offering support, especially in adversity. Reject undue influence and conflicts of interest.
  • Dedication: Be willing to surrender unconditionally to the fulfillment of duty to others with care, courtesy, and service.

Human Values

Physical Values

Skills, Hygiene, Order, Elegance, Austerity, Balance

Vital Values

Activity, Health, Energy, Exercise Capacity

Affective Values

Happiness (a healthy joy that makes us feel good about ourselves), Empathy, Courtesy, Trust, Temperance, Gratitude, Good Humor, Enthusiasm, Naturalness, Optimism, Patience, Joy, Respect, Firmness, Serenity, Adaptability

Intellectual Values

Discernment, Intelligence, Common Sense, Discussion, Global Vision, Discipline, Honesty, Understanding, Logic, Effectiveness, Accountability, Organizational Capacity, Imagination, Creativity, Dialogue, Initiative, Attention, Concentration, Objectivity

Moral Values

Kindness, Love, Justice, Willpower, Courage, Loyalty, Altruism, Love of Truth, Heroism, Dignity, Authenticity, Fairness, Humanity, Fraternity, Exemplary Conduct, Sense of Duty, Solidarity, Tolerance, Purpose, Inner Strength, Service, Commitment, Freedom

Spiritual Values

Everything related to the Sacred, Beauty, Harmony, and Intuition. Idealism, Dialogue, and Interior Life, Transcendence

Metaphysical Values

The Good, the Beautiful, the True, the Just

Dehumanization in Patient Care

Situations of physician dehumanization include:

  • Imposed attention and lack of empathy.
  • Disrespect and mockery of the patient.
  • Differentiated services and better information for private patients.
  • Blocking attention due to fees.

Ethical Issues

  • Bribery: Accepting gifts or royalties in exchange for special treatment or favors.
  • Excessive Loyalty: Lying to cover up improper conduct of a supervisor or doing whatever they tell you.
  • Lack of Dedication and Commitment: Wasting time and not making the most of your work.
  • Breach of Trust: Taking materials from the institution for personal use or misusing available resources.
  • Collusion: Remaining silent and not reporting a wrongdoer, motivated by friendship or fear.