Chapter

3
Dra. Fernanda Jiménez, Mgst. Edu.
Ing. Jennifer Yépez, MSc.
Universidad Politécnica Salesiana
To analyse the structure of
deontological principles
1. Justification of the principles
2. Application of the principles
2.1. Autonomy principle
2.2. Justice principle
2.3. Nonmaleficence principle
2.4. Beneficence principle
3. Articulation of the principles
• Our ethical guidelines are guided by five moral
principles (Kitchener, 1984)
• These moral principles can not address all
situations; however they are the foundation to
clarify different issues.
• The 5 principles are:
• Autonomy
• Justice
• Nonmaleficence
• Beneficence
• Fidelity
Autonomy

• Autonomy comes from two Greek words: auto

and nomos, which mean “self-rule”.
• It is related with the concept of independence.
• An individual should have the freedom of
choice and action.
• There are two considerations:
Autonomy

a. People’s decisions and their values may or

may not be accepted within the society and
these decisions can infringe the rights of
others.
b. A person must have the ability to make sound
and rational decisions.
Autonomy

• Example: Client’s legal right and Client’s

cognitive ability.

Although a client has a legal right to behave in a

particular way, it may be difficult to honor this
right if the individual is acting foolishly or
irrationally.
Justice

• “Treating equals equally and unequals

unequally but in proportion to their relevant
differences” (Kitchener, 1984)
• If an individual is treated differently, it must be
a necessity and appropriateness for this
different treating.
• Equal and fair distribution of resources, taking
into account benefits and troubles of a
decision.
Justice

• Example: When a non-profit organization

wishes to donate low or non-cost pediatric
dental services to a community; but, they can
give services to only 40 children per month.
Justice requires a fair and unbiased method to
select those children who will be receive this
attention.
Beneficence

• This means to do good, to be proactive and to

prevent harm when it is possible.
• Taking positive action to help others.
Beneficence

• Example: A case manager from a Healthcare

Insurance must take active steps to promote
and benefit the welfare of the client; for
example, evaluating the quality of a medical
attention when it is not covered by the
insurance.
Nonmaleficence

• Not causing harm to others.

• “Above all do no harm”.
• This principle involves the idea of not causing
intentional harm and not participating in
actions that can cause harm others.
Nonmaleficence

• Example: Doctors in a hospital must comply

with the relevant standards to provide quality
service to their patients in order to heal them.
Fidelity

• It involves loyalty, faithfulness and honoring

commitments.
• This principle obligates to tell the truth.
• It has three main benefits:
• Promotes: accountability and professionalism.
• Enhances: the quality of relationships.
• Facilitates: the building of trust.
Fidelity

• Example: A bank practices veracity when the

institution communicates honestly, sharing
relevant, accurate, clear and understandable
information with their clients.
• An ethical professional acts according to all the
ethical principles and to the extent that
situations allow him to do it.
• It is required to unify, classify or articulate the
different perspectives and criteria related with
the ethical principles.
• The variety of principles causes problems only
when they collide against each other.
• Beneficence attack autonomy and it may fall
into paternalism.
• A person who follows autonomy may conflict
with nonmaleficence.
• A person who prioritizes nonmaleficence, at
some point he will have to put limits on
autonomy, beneficence and even justice.
Think about a doctor who knows one of his patients
has a severe contagious disease; however, this
patient doesn’t take the necessary measures to
prevent the spreading of the disease to those who
are around him.
On the one hand the doctor is obliged to respect his
patient’s privacy and autonomy. On the other hand,
the doctor is also obliged to avoid damages to third
parties and to follow the nonmaleficence principle.
Therefore, the doctor could interfere with his
patient’s privacy in order to avoid a greater damage.
• There is not an steady order among the
different principles rather their relationship is
constantly changing.
• Each principle tries to give different ideas and
to guide through different situations,
considering what each of them is trying to
protect, safeguard and promote.
• Therefore, according to the situations some
ethical principles can overcome others.
• Articulation of the principles should be a
constant conversation among perspectives of
professionals, clients, users and people who
are in charge of different institutions.
• Professionals are the experts who know what
to do and how to do it.
• Clients and users are the main affected with
the services and products they get, as they are
who need, wish, ask for and receive the
professional services.
• People who are in charge of different
institutions, are also in charge of set up
priorities and give resources according to
criteria of justice.
• A professional must act looking for the benefit
of his clients or users.
• A good professional will be ethical and he also
will care about others trying to respect his
clients’ dignity and rights.
A Practitioner's Guide to Ethical Decision Making.
(2017). Retrieved from
http://alabamacounseling.org/pdf/ACAguide.pdf
Ethical Principles and the Case Manager | CCMC’s Case
Management Body of Knowledge (CMBOK). (2015).
Cmbodyofknowledge.com. Retrieved 10 June 2017,
from
https://www.cmbodyofknowledge.com/content/ethica
l-principles-and-case-manager