[Music] many bioethicists have found it helpful to draw certain basic underlying principles these principles of autonomy beneficence non-maleficence and justice are broad and their interpretation and application in particular situations can become very complex and difficult autonomy reflects respect for persons it is the idea that key decisions about a person's life should if possible be made by that person rather than anyone else the decision of whether a competent adult will receive palliative care rather than so-called heroic measures when battling a fatal disease should be made by the patient not by someone else beneficence means that a physician should strive to do what is best for the health of a patient it includes the argument that we as a society should arrange for doctors to treat patients with serious illnesses even if these patients cannot afford treatment non-maleficence means that health care professionals should strive not to harm patients for example doctors should not ordinarily provide treatment in which likely harmful side effects are known to outweigh the likely benefits just as calls upon us to do what is fair and equitable many argue that in contrast to luxury consumer goods everyone should receive decent health care regardless of ability to pay for instance new life-saving vaccines should be made available to poor patients as well as wealthy patients each of these principles may seem fairly straightforward but when two or more such considerations compete interpreting and applying these principles becomes quite complex for example if a patient requested procedure in which the risks outweigh the benefits how does a physician regard autonomy while upholding his or her commitment to nominal Ephesus striving to fulfill the duty of beneficence can raise questions of justice in the case of organ transplantation resources are not just and sufficient for best care they are insufficient to provide everyone with the care necessary to stay alive how should these resources be allocated if justice requires a universal health coverage plan but societal resources are limited how much ought to be covered which priorities ought to be set how much should society spend on prenatal and early childhood care and how much on high-end quality palliative and hospice care at the other end of life so far as palliative end-of-life care generally concerns only a relatively short amount of time in a person's life does that mean that proportionately fewer resources should be expended on such care or does the moral significance of how our lives come to their final end worn an appropriately greater commitment of human and financial resources how should these and so many other complex questions be answered we can begin by emphasizing the short list of very basic bio ethical principles