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, nonmaleficence, and justice, serve as fundamental guidelines in medical decision-making (Rasool et al., 2023). However, the relative importance of these tenets varies in relation to cultural perspectives, societal values, and individual worldviews. From my point of view, the order in which these principles are ranked when examining their impact on the health and safety of diverse populations should prioritize justice first, followed by beneficence, nonmaleficence, and autonomy.

Justice (Highest Priority)
Ethical medical practice depends fully on justice, which in turn guarantees fairness and equal distribution of healthcare resources. In the case of diverse populations, social determinants of health largely contribute to disparities in care (Rasool et al., 2023). These inequalities can be mitigated by prioritizing justice by encouraging the establishment of policies that do not discriminate on the basis of socioeconomic status, race, or gender and by promoting policies for access to healthcare. Without justice, those without a means to attend to their basic medical needs mean nothing to autonomy.

Beneficence
The principle of beneficence requires healthcare providers to act in the best interest of the patient. This refers to working practically to increase public health outcomes in a range of populations via preventative measures and health education in communities (Cheraghi et al., 2023). Beneficence is a commitment to better health rather than just respect for individual choices if consequence consideration holds no significance.

Nonmaleficence
The ethical standard of nonmaleficence, or “no harm,” is crucial. While it is sometimes paired with beneficence, it comes in slightly lower due to some interventions that cause temporary harm (e.g., chemotherapy, surgeries) that may be required in order to create a greater good (Jansen, 2022). In public health, nonmaleficence preserves certain populations from the injurious effects of bad policies, neglect, or ill-defined experiments.

Autonomy (Lowest Priority in Population Health)
Autonomy is important in respecting individual rights, and the mere prioritization of autonomy can bring some ethical dilemmas in the context of a diverse population. For instance, some public health measures, like vaccination mandates or quarantine exclusion, impede the exercise of individual freedom in favor of the common good. While the rights of the individual should be respected, they should not be allowed to overwhelm measures required for public health and safety.

In summary, autonomy is a core ethical principle, but in situations where populations are diverse, justice should be a primary consideration for equal healthcare access. Ethical medical decision-making is guided by beneficence and non-maleficence, while autonomy is important but should not undermine the well-being of the community as a whole.

References

Cheraghi, R., Valizadeh, L., Zamanzadeh, V., Hassankhani, H., & Jafarzadeh, A. (2023). Clarification of ethical principle of the beneficence in nursing care: an integrative review. BMC Nursing, 22(1), 1-9. https://link.springer.com/article/10.1186/s12912-023-01246-4

Jansen, L. A. (2022). Medical beneficence, nonmaleficence, and patients’ well-being. The Journal of Clinical Ethics, 33(1), 23-28. https://www.journals.uchicago.edu/doi/abs/10.1086/JCE2022331023

Rasool, S., Hussain, M., Saleem, H. H., Sultan, S., Akhter, S., & Aslam, E. (2023). Islam and four principles of biomedical ethics: from theory to practice. Russian Law Journal, 11(11S), 577-582. https://cyberleninka.ru/article/n/islam-and-four-principles-of-biomedical-ethics-from-theory-to-practice

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