Table 1 Expressions of the four principles of bioethics within the two moral orientations
From: The ethics of everyday practice in primary medical care: responding to social health inequities
| Â | Social Justice and Human Rights | Care and compassion for the vulnerable |
|---|---|---|
Beneficence | Doing good involves ensuring the individual gets the health care they need even when their social position limits their opportunities for health achievement (this may involve reorienting services: ensuring services are available, accessible and appropriate). | Doing good involves providing the best available clinical care to each individual within a compassionate, caring and empathic context. |
Non Maleficence | Doing harm involves paying no attention to the social contextual factors at play in a patient's illness presentation and experience. | Doing harm involves changing the care one provides on the basis of a person's social position. Everyone should be treated in the same way. |
Autonomy | Promoting autonomy involves helping individuals overcome the social limits that frame their choices through full information to promote access to clinical care. | Autonomy flows from the full attention, support and engagement of the clinician in a relational encounter. |
Justice | Justice is premised on the notion of natural rights to equitable access to health care as an element of a free, dignified and meaningful life. | Justice will ensue if practitioners see beyond a patient's social context to the person within. Physicians have a duty to respond to inequities through caring for patients from all backgrounds. |