Four principles of medical ethics
What it means
Beauchamp & Childress's framework: AUTONOMY (respect the patient's right to make their own informed decisions), BENEFICENCE (act in the patient's interest/do good), NON-MALEFICENCE (avoid/minimise harm — 'first do no harm'), and JUSTICE (fairness in distribution of resources and treatment). Most ethical dilemmas are analysed by weighing these, which often conflict.
Worked example
Respecting a Jehovah's Witness's refusal of blood (autonomy) over the team's wish to transfuse (beneficence) — autonomy of a capacitous adult prevails.
In the exam
A team analyses a dilemma by weighing the patient's right to choose against their wish to do good, avoid harm, and use resources fairly.
What settles it
For a CAPACITOUS adult, autonomy generally trumps beneficence — you cannot treat against a valid refusal even to save life.
Classically confused with
GMC Good Medical Practice / duties of a doctor
Source: Beauchamp & Childress