Ethical Principles

Different ethical theories exist and theories can be applied to different situations to
inform our thinking and support decision making. Understanding the key ethical theories
enables practitioners to utilise this knowledge to rationalise, defend and recommend the
correct actions in the situations encountered in practise.

Consequentialism

Consequentialist ethics holds the view that the correct moral response is solely related
to the outcome, or consequence, of the act. This monist theory is based on a strict
adherence to pursuit of the outcome which will result in the greatest good for the
greatest number. Determining what constitutes the greatest good in healthcare can be
challenging.While this theory has attractive elements, and can be seen to influence
processes such as triaging, it not recognises the rights of individuals and, if taken to its
logical conclusion can endorse unacceptable acts.

Deontology

Deontological ethics are based on duties and rights and respect individuals as ends in
themselves. It places value on the intentions of the individual (rather than the outcomes
of any action) and focuses on rules, obligations and duties. Deontology requires
absolute adherence to these obligations and acting from duty is viewed as acting
ethically. One of the key criticisms in healthcare is that applying a strictly deontological
approach to healthcare can lead to conflicts of interest between equally entitled
individuals which can be difficult or even seemingly impossible to resolve.

Virtue Ethics

Virtue ethics relate to the internalised moral characteristics, rational thought and
practical wisdom of a virtuous person who possesses and lives the virtues. The traits
must be possessed as stable, fixed and reliable. While this is a particularly attractive
value in healthcare professionals there is debate over how, when and to what extent
these virtues are acquired and how they are influenced by societal values.

The challenge with this form of ethics can be the lack of clear guidance. The
requirement to act “as a virtuous person would act given the situation” can make it
difficult to identify the morally correct course of action where more than one alternative
may be open to the practitioner and patient.

The virtuous characteristics of healthcare professionals are highly valued. Codes of

conduct and guidance developed by professional regulators who emphasise the
character of a registrant as one who can be relied upon to do the right thing in each
situation.  The Berwick Report– A promise to Learn-a commitment to act in 2013 also
places a strong emphasis the quality and character of staff in creating safe healthcare
system.
Principlism

Principlism is a commonly used ethical approach in healthcare and biomedical

sciences.  It emphasises four key ethical principles of autonomy, beneficence, non-
maleficence, and justice, which are shared by most ethical theories, and blends these
with virtues and practical wisdom.  This is an attempt to bring together the best
elements of ethical theories which are compatible with most societal, individual or
religious belief systems.