Overview
This lecture introduces the four pillars of medical ethics—autonomy, beneficence, non-maleficence, and justice—explaining their significance in medical school interviews and clinical practice.
Importance of Medical Ethics in Interviews
- Medical schools assess your understanding of ethical principles due to their prevalence in clinical scenarios.
- Ethical questions reveal your logical reasoning and awareness of key issues in medical practice.
The Four Pillars of Medical Ethics
Autonomy
- Autonomy means a competent adult has the right to make decisions about their medical treatment.
- Doctors must provide all relevant information so patients can make informed decisions.
- Patients can accept or decline offered treatments but cannot demand any treatment not deemed suitable by doctors.
Beneficence
- Beneficence requires doctors to act in ways that benefit the patient and promote their welfare.
- What is considered beneficial may differ between the patient and the doctor, so patient beliefs should be considered.
Non-maleficence
- Non-maleficence means "do no harm" and obliges healthcare workers to avoid causing harm or suffering.
- Most treatments have risks, so doctors must balance benefits against potential harms.
- The rule of double effect allows actions that may have harmful side effects if the primary intention is to do good.
Justice
- Justice focuses on fairness in the distribution of healthcare resources and treatment.
- Equal cases should be treated equally, but unequal cases may require different approaches.
- Distributive justice addresses how limited resources are allocated and the issue of regional disparities in care (postcode lottery).
Application of the Four Pillars: Mock Question Example
- Autonomy supports patient choice, but does not permit demanding all possible treatments.
- Justice and limited resources mean not all treatments can be funded for everyone.
- Beneficence supports doing good, but non-maleficence warns against unnecessary side effects from excessive treatments.
- A balanced answer considers benefits, harms, resource limitations, and fairness.
Key Terms & Definitions
- Autonomy — the patient’s right to make informed decisions about their medical care.
- Beneficence — the ethical obligation to act in the patient’s best interest.
- Non-maleficence — the duty to avoid causing harm to patients.
- Justice — the principle of fairness in healthcare access and resource allocation.
- Rule of Double Effect — an action with both good and harmful effects is acceptable if harm is not the main intent.
Action Items / Next Steps
- Review practical applications of the four pillars in common ethical scenarios.
- Practice answering mock interview questions using the four pillars to structure your responses.