A
main framework of bioethics attempts to balance the four main principles of bioethics. These
principles are:
- Autonomy: respect for a patients individuality
which urges the caretaker to both ensure that the patient fully understands the treatment course
and the risks and to allow the patient to make choices without coercion or coaxing; - Justice: consideration of fairness that urges the caretaker to strive to equitably
distribute benefits, risks, costs, and resources as well as the burdens of new technology and
research; - Beneficence: a moral standard which obliges the caretaker to do
good, act for the benefit of others; and - Non-maleficence: another moral
standard that requires the caretaker to cause no harm to the patient or society in
general.
When these four principles are balanced in order to
form a framework of bioethics, caretakers will be called, first, to ensure the patient
understands the treatment options clearly. This means that the team must take the time to
carefully communicate care options to patients. At the same time, caretakers must be active
listeners, ensuring they fully understand the patientss values and wishes, so that they can best
inform and advise the patient. Finally, in this framework, caretakers must remain up to date on
training and understand current best practice and the ethical implications, so they can best
weigh the considerations of justice, beneficence, and non-maleficence whenever they provide
care.
This framework provides guidance that can push caretakers to be
cautious and thoughtful when they treat patients and allow for more patient-centered care;
however, it does have limitations. Despite, caretakerss best efforts to explain medical
prognoses and risks to a patient, many times, patients will not fully grasp these concepts.
Sometimes, this will be because many patients are not trained medical professionals. Other
times, this will be because the illness has set limits on the patientss ability to understand
these types of discussions. Therefore, the caretaker may be relying on a designated proxys best
estimation of what the patient would want.
Other considerations, such as
non-maleficence, also cause complications in this framework because of the competing forms of
harm that may occur. For instance, when a patient is given hope about a certain treatment that
has low success chancesthe harm in not trying the treatment is a physical harm. However, the
harm in trying the treatment and failing may cause the patient both a physical and emotional
harm (such as sadness or depression). Many times, it will not be easy for the caretaker to weigh
harms and be certain of which path causes less harm.
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