Principles of clinical ethics and their application to practice.

An overview of ethics and clinical ethics is given. The 4 main ethical principles- beneficence, nonmaleficance, autonomy and justice- are defined and explained. Informed consent, truth-telling and confidentiality spring from the principle of autonomy and each of them is discussed. In patient care situations, not infrequently, there are conflicts between ethical principles (especially between beneficence and autonomy). A four-pronged systematic approach to ethical problem-solving and illustrative cases of conflicts are presented. Comments following the cases clarify the resolution of these conflicts. A model for patient care that integrates the ethical aspects (intertwined with professionalism) with clinical and technical expertise desired of a physician is illustrated.