The 4 pillars

of Ethics

By: Kimberly S. Chapman

The 4 pillars of ethics

• Autonomy
• Nonmaleficence
• Beneficence
• Justice
 Autonomy
• In medicine, autonomy refers to the right of the patient to retain control
over his or her body. A health care professional can suggest or advise or
educate, but any actions that attempt to persuade or coerce the patient
into making a choice are violations of this principle.
• In healthcare, autonomy assumes a certain level of respect for persons
and their ability to take actions that affect their own health.
The 4 aspects of autonomy: informed consent, confidentiality, truth telling
and fidelity

• Informed consent needs to have a competent client and full disclosure.

• Confidentiality includes keeping all information about the person’s
identity , family, health status, and treatment procedures private. Most
common referred to as HIPPA.
• Truth telling: as Kant would say the truth telling meets the categorical
imperative and telling the truth should be universal.
• Fidelity is from a Latin word meaning faithful.
 Beneficence

•  means that healthcare professionals should act toward their patients

with charity, mercy, and kindness.

• Can also be exhibited as consistent respect.
 Nonmaleficence

• refers to doing no harm, which provides the backbone of

the Health Insurance Portability and Accountability Act (HIPAA)
and medical oaths.
• Since some treatments can cause harm, insertion of urinary catheter,
modern medicine includes the need to prevent unnecessary harm in its
definition of nonmaleficence
 Justce

• Is influenced by individual perceptions and circumstances

• Can be divide into different categories
• Procedural justice
• Patient justice
• Distributive justice
• Market justice
• Social justice
 legal

• Informed consent
• Competence & voluntariness

• Privacy

• Client’s rights

• End of life issues

 Sources

• The Joint Commission. 2016. Comprehensive Accreditation Manual glossary.

• Morrison, E. E. (2020). Ethics in health administration: A practical approach for decision makers (4th Ed). 
Sudbury, Mass: Jones and Bartlett Publishers.

• Paton, F., (2019, April 29). Veracity: Is it okay to lie to our patients? Retrieved March 09, 2021, from
https://nurseslabs.com/veracity-in-nursing-is-it-okay-to-lie-to-our-patients/

• Woodward B. (2001). Confidentiality, consent and autonomy in the physician-patient relationship.

Health care analysis : HCA : journal of health philosophy and policy, 9(3), 337–351.
https://doi.org/10.1023/A:1012910016814