Ethical principles do not provide a straightforward guide that guarantees the making of an ethically correct decision, nor can they offer guidance about ranking when the principles appear to conflict with one another.
Instead, they point only to considerations that should be weighed when making decisions.
Autonomy. The duty to respect and promote individuals´ choices for themselves in achieving what they believe to be in their best interests. It becomes limited if it infringes on the best interests of others.
This duty also includes respect for
confidentiality and
privacy.
Privacy is related not only to information, but also to freedom from unnecessary or unwanted interference by others.
Respect for autonomy also underlies both
informed consent and the drive toward using
advanced treatment directives.
Beneficence. The duty always to act in the best interests of the patient, client, or resident; it must be distinguished from
paternalism.
Non-maleficence. The duty to do not harm, and to protect the others from harm. Included in this duty is to maintain one´s professional competence.
In the palliative care setting, possible violations of this duty include:
- Insisting that patients confront the reality of their approach to death.
- Destroying hope.
- Providing unnecessary sedation.
- Failing to stop treatments when their burdens begin to exceed their benefits.
Distributive justice. All persons in society, being of equal moral worth, should be treated fairly.
Briggs M et al. A handbook of healthcare ethics and institutional ethics for staff in healthcare institutions. Edmonton. The Bioethics Centre. 1994. pp. A:11-12
Storey P and Knight CF. Unipac six: ethical and legal decision making when caring for terminally ill. Reston, Virginia. American Academy of Hospice and Palliative Medicine. 1998. pp. 15-16.