The Four Pillars of Medical Ethics

By Siddhant Kansal

Medicine as we know it is one of the most important branches of research and development there are. Without the ability to rejuvenate and treat people, there is no prospect of growth and without growth, there is no development. Without development, there is no learning and learning is the backbone of any civilisation.

As such, it is very important for medical professionals, the people who deal with matters of life and death every day, to be extremely well-adjusted and able to make the right decisions every single time. However, despite all of the medical jargon and knowledge bestowed upon medical students in their training, all judgements that medical professionals and almost everyone have to make are either based on cognitive or affective judgement. 

Cognitive Judgement is the type of judgement where decisions and judgements are based on content information or actual given knowledge, whereas affective judgement is they type of judgement based on feelings or emotions. In this article, the latter will be focused on. Most medical professionals will be making decisions on the basis of the four pillars of medical ethics - beneficence, non-maleficence, autonomy and justice. For a decision to be considered ethical, it must abide all 4 of these criteria. 

Beneficence refers to each treatment and every course of action being prescribed and taken with good intentions, to as many people as possible. This is one of the more obvious examples of a parameter that you would think medical professionals would need to keep in mind, but what people don’t realise is that what the patient thinks is best and what is actually best for them are sometimes very different things. One example of this is of pain during treatment. Patients may prefer a course of action which alleviates them of pain, but may not be effective in curing their ailment. A doctor would prescribe the treatment most effective at ridding the ailment, even if it may cause the patient more pain in the short term, even though alleviating pain is something that the doctor would keep in mind. Non-maleficence is just the intention to provide as little pain as possible.

This raises the question of the patient’s right to make their own decisions, calling upon the principle of autonomy. Autonomy concerns the patient’s rights to make their own decisions, especially when the medical practitioner offers them a choice of treatments. Medical practitioners can never make a decision for a patient, unless they are intervening when a patient is making the wrong choice, perhaps out of lack of mental capability as a side effect of the ailment or medication at that time, and if no-one has power of attorney.

Justice refers to the treatment of all patients with equal dedication and professionalism. This is very important, as it is crucial that all treatment is fair and one patient’s benefit is not another patient’s harm and that all decisions are legal and approved. 

This is how medical decisions are made and these 4 pillars are the key to making properly informed decisions as a medical professional.