Ethics in Medicine and 4 Moral Principles in Ethics

Ethics in Medicine
Medical ethics describes the moral principles by which a Doctor must conduct
themselves. You need to understand the concept of medical ethics when you’re
applying for Medical School, but you aren’t expected to be an expert.
It’s worth being aware that medical ethics is a changing ideal. Something that might
have been considered ethical 30 years ago may not be today – and what we think is
ethical right now may change in the future.
Why Is Medical Ethics Important?

Medical professionals frequently find themselves facing moral questions and ethical
dilemmas in their line of work. Medical ethics provide a framework to help them make
judgement calls which are morally sound and right for the patient in question.
It’s essential for aspiring Doctors to have a good moral compass and a solid grasp of
medical ethics so they can consistently do what is best for their patients.
Four Pillars of Medical Ethics

The four pillars of medical ethics are:
1. Beneficence (doing good)

2. Non-maleficence (to do no harm)
3. Autonomy (giving the patient the freedom to choose freely, where they are able)
4. Justice (ensuring fairness)
These four principles represent a framework for analysing the best action to take in a
given situation. To use this approach, you must consider whether your actions are in
compliance with each of the four pillars.

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Example Ethical Dilemma

A good example of an ethical dilemma relating to Medicine is that of surgery.
Imagine that a patient has appendicitis and the surgeons believe that surgery is
necessary. Technically, making an incision into the patient’s skin is causing “harm” to
the patient; however, this is done with good intent as removing the inflamed appendix
eliminates the risk of progression to rupture and peritonitis.
Surgery would be offered to the patient based on their clinical need and they will have
the right to make an informed decision. The four principles would, therefore, support
performing this surgery.
Medical Ethics Concept: Consequentialism

Consequentialism is an ethical ideology that states the morality of an action is
dependent purely on its consequences. A simpler way to phrase this would be that the
“ends justify the means”. If your action has an overall benefit, then it does not matter
about the action itself.
Example: Your patient has a terminal illness and is not likely to survive the operation
she is about to undertake. Just as she is about to be anaesthetised, she asks you:
“Doctor, will I be okay?” A consequentialist ideology supports that lying in this
circumstance is acceptable, even though lying itself is not a moral action.
Medical Ethics Concept: Utilitarianism

Utilitarianism says the best action is that one that brings about the best increase in utility
(benefit). Utility is generally considered on a broad scale, often taking into consideration
wider society and not just the patient in question. It’s a form of consequentialism.
Example: You have a sum of money to either fund a very expensive treatment for one
patient with a rare disease or five patients with a very common and easy-to-treat
disease. Utilitarian ethics dictates that treating the five patients is morally superior as a
greater overall benefit is achieved.
Medical Ethics Concept: Deontology

Deontology is also known as “duty-based ethics”. This ideology states that the correct
course of action is dependent on what your duties and obligations are. It means that the
morality of an action is based on whether you followed the rules, rather than what the
consequence of following them was.
This is in direct contrast with consequentialism.
Example: If your terminally ill patient asks if they’ll be ok after a surgery they’re unlikely
to survive, a deontological approach would suggest you don’t lie to comfort them. That’s
because according to this concept, lying isn’t morally acceptable because it’s our
obligation not to lie – no matter the consequences.
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Generally speaking, consequentialism may be the most relevant guide to thinking about
the broad aims of healthcare – and deontology-based guidance is the one most
commonly seen in Medicine.

How To Develop Medical Ethics Knowledge
One of the best ways to develop your understanding of medical ethics is to practice
analysing situations using ethical frameworks and ideologies. You can do this on your
own, with a teacher, or with a fellow Medical School applicant who could give you their
perspective and share ideas. Try to compare the outcomes given by different
frameworks and consider the implications of this.
Make sure you stay up-to-date with the latest health news – and see how these ethical
frameworks apply to what’s currently in the news.
Medical Ethics Examples

At Medical School interviews, medical ethics is a big part of the selection process. It’s
highly likely that you’ll be asked ethics questions or face an MMI station designed to test
your understanding of these concepts.
Some key medical ethics examples that you should be aware of for your interview are:
 The Charlie Gard and Alfie Evans cases
 Medicinal cannabis
 The handling of the COVID-19 pandemic
 Abortion
 Euthanasia
 Organ donation
When you answer ethics questions, you don’t have to list each of the four principles of
ethics and outline these concepts – instead, pick a couple that are really relevant to
show the interviewer that you’re aware of medical ethics in general.

And remember – you may not be expected to make decisions yet. The key thing to do in
your interview is to show you understand the issues by discussing how the key ethical
principles relate to the question. If the interviewer pushes you for an opinion, make sure
you can back up what you choose with some ethical reasoning.

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Ethics in Medicine

applying for Medical School, but you aren’t expected to be an expert.

ethical right now may change in the future.

Why Is Medical Ethics Important?

Four Pillars of Medical Ethics

1. Beneficence (doing good)

compliance with each of the four pillars.

INTERVIEW COURSEMMI CIRCUITS

Example Ethical Dilemma

eliminates the risk of progression to rupture and peritonitis.

performing this surgery.

Medical Ethics Concept: Consequentialism

about the action itself.

“Doctor, will I be okay?” A consequentialist ideology supports that lying in this

circumstance is acceptable, even though lying itself is not a moral action.

Medical Ethics Concept: Utilitarianism

greater overall benefit is achieved.

Medical Ethics Concept: Deontology

consequence of following them was.

This is in direct contrast with consequentialism.

obligation not to lie – no matter the consequences.

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INTERVIEW & MMI PACKAGES

commonly seen in Medicine.

frameworks and consider the implications of this.

frameworks apply to what’s currently in the news.

Medical Ethics Examples

your understanding of these concepts.

 The Charlie Gard and Alfie Evans cases

 The handling of the COVID-19 pandemic

show the interviewer that you’re aware of medical ethics in general.

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