Chapter 2 Professional Ethics 27 Copyright Goodheart-Willcox Co., Inc. Ethical Principles After thousands of years of development and debate about philosophical, religious, political, and economic principles, and the publication of hun- dreds of books on medical ethics, a consensus has evolved on the general values that serve as the basis for professional medical ethics. This does not mean there is universal agreement. For example, people continue to debate whether decisions should be based on the rights of the individ- ual, the overall good to society, the happiness of the individual, or the inherent goodness or evil of certain acts. This is, in part, why the study of historically recognized philosophers such as Confucius, Plato, Aristo- tle, Hobbes, Kant, Mills, and others is included in many college courses. Despite continued debate, the following principles commonly guide medical professionals in providing patient care: 1. The concept of autonomy means that a person has a certain amount of “self-rule.” A patient has the right to refuse or choose treatment. This idea is based on respect for the individual’s ownership of and right to rule his or her own body. A patient’s mental capacity and freedom from duress to make an informed and free decision must be considered in certain cases. The concept of respect for persons is derived from this principle. In respect for a patient’s autonomy, a healthcare provider must obtain permission before administering treatment. For example, if a physician thinks that a blood transfusion will help a patient, he or she must first fully explain the pros and cons of the procedure and then obtain the patient’s permission before performing that procedure (Figure 2.7). This is known as informed consent (see Chapter 9 for further discussion of informed consent). Not all patients will give consent, though. For example, Jehovah’s Witnesses believe that it is wrong to accept a blood transfusion, even in a life-threatening situation. Therefore, a Jehovah’s Witness patient may refuse the procedure. If that happens, the physician must respect the patient’s autonomous choice and still carry out his or her ethical responsibility to the patient. In this case, informed by community practice and legal provisions for the free exercise of one’s religion, the physician gives greater priority to the principle of patient autonomy than to other values. autonomy an individual’s right to self-determination that is free from undue interference from others Donenko Oleksii/Shutterstock.com Figure 2.7 Informed consent is important because it means that patients are fully aware of the procedures that they are agreeing to or refusing.