Ethical issues in family practice

Abstract

The Raison d'etre principles in biomedical ethics have clearly become what are referred to as the four principles. These can be summarized as the Principles of Beneficence, Nonmaleficence, Respect for Autonomy and Justice. A doctor has to do good whilst avoiding harm and at the same time respect the autonomous nature of the patient's wishes whilst keeping a balance with justice towards the patient and society in general. Although 'principlism', as the theory is often dubbed, has been shown to help us little in moral problem solving where dilemmas are concerned such as whether to take one off a respirator or not, they are nevertheless useful guidelines in orienting one's thinking in the ethical process. Thus the four principles find a solid role in the teaching of ethics to health care professionals. What is important is that these principles form part of the phenomenon of the doctor-patient relationship and that it is the relationship that concerns ethics more than a set of rules. Thus more than being a 'code of ethics', the relationship is about the 'virtuous act'. In this sense, truth telling is not merely a rule but is an ethical norm which should be imparted with compassion. This virtue is as important as the rule itself.