PHI-413V Topic 3 DQ 1

The four principles of biomedical ethics, especially in the context of bioethics in the United States, have often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values. Based on your worldview, how do you rank the importance of each of the four principles in order to protect the health and safety of diverse populations?
Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to the “Discussion Question Rubric” and “Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively.
American Association of Colleges of Nursing Core Competencies for Professional Nursing Education
This assignment aligns with AACN Core Competencies: 3.1

Solution

The four principles of biomedical ethics—autonomy, beneficence, non-maleficence, and justice—form the cornerstone of modern healthcare ethics. While the American healthcare system has traditionally emphasized autonomy, a more nuanced approach is necessary when considering diverse population health needs. From my perspective, informed by both clinical evidence and ethical frameworks, justice should be the primary principle, followed by non-maleficence, beneficence, and autonomy. Justice as the foremost principle ensures equitable distribution of healthcare resources and fair access to care across all populations. This positioning acknowledges that health disparities often stem from systemic inequities rather than individual choices. Beauchamp and Childress (2019) argue that justice in healthcare extends beyond mere distribution of resources to include addressing social determinants of health and ensuring healthcare systems serve all communities equitably. Non-maleficence takes second priority because the obligation to “do no harm” must apply universally across populations, regardless of individual preferences or resource constraints. This principle becomes particularly crucial when considering public health measures that affect entire communities, such as vaccination programs or environmental health policies. Beneficence follows as the third priority, focusing on actively promoting health and preventing disease across populations. According to Gillon (2020), beneficence in public health often requires balancing individual benefits against collective good, particularly in resource-limited settings or during health crises. While autonomy remains important, I place it fourth when considering population health. This ranking acknowledges that individual choices must sometimes be balanced against broader community health needs. For instance, during infectious disease outbreaks, certain autonomous choices might need to be limited to protect vulnerable populations. However, this doesn’t mean disregarding autonomy entirely—rather, it suggests implementing it within the context of other ethical principles. This ranking reflects the understanding that protecting population health often requires prioritizing collective wellbeing while still respecting individual rights. The challenge lies in maintaining this balance while ensuring that vulnerable populations are not disproportionately affected by healthcare decisions.

References:

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Gillon, R. (2020). Ethics, medicine and public health: What’s ethics got to do with it? Journal of Medical Ethics, 46(1), 15-21.

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