The Four Pillars of Medical Ethics

1. Autonomy

Autonomy, as we know, is what we regard as the right to think and act with complete freedom and independence. There must be absolute respect for the right of a patient to make decisions in that framework, even when doctors and family members or others believe the patient is coming to the wrong decision. The patient can be helped in the decision- making process by being given important information. However, the uninformed opinion of others is subjective and not helpful.

2. Beneficence

Beneficence is what is in the best interests of the patient. Very often, the best interests of the patient is at odds with patient autonomy, when the patient is choosing a route through the sickness, which is not in his/her best interests.

3. Non Maleficence

Non-maleficence is often stated simply as “Do no harm.” Although it looks clear enough that we are required to avoid inflicting harm on anyone at all, again the problem arises when there is a conflict between meeting the best interests of our patient and doing no harm.

4. Justice

Justice is a compound principle with four separate strands:
(a) Distributive Justice
(b) Respect for the law
(c) Rights
(d) Retributive Justice

So, in our short course, we will look at examples where there is conflict and where they all weigh in together. It is easy to see how difficult the task of the judiciary is when cases involving these questions come to the High Court/the Supreme Court.