Medical ethics: four principles plus attention to scope
Open accessAbstract
The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and justice--plus concern for their scope of application. It offers a common, basic moral analytical framework and a common, basic moral language. Although they do not provide ordered rules, these principles can help doctors and other health care workers to make decisions when reflecting on moral issues that arise at work.
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These principles were originally proposed by Beauchamp and Childress, and extended to consider scope of application by Gillon.
“These principles were originally proposed by Beauchamp (who leant toward a consequentialist or utilitarian position, focusing on outcomes of decisions for the patient and others) and Childress (a deontologist focusing more on the clinician's duties) (85), and extended to consider scope of application by Gillon (86).”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [86]
Cites
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A governance model for the application of AI in health care
Reddy, S., Allan, S., Coghlan, S., & Cooper, P. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocz192 · Cited by 979 · see citing works
Responsible AI—two frameworks for ethical design practice
Peters, D., Vold, K., Robinson, D., & Calvo, R. A. (2020) · IEEE Transactions on Technology and Society · doi:10.1109/tts.2020.2974991 · Cited by 293 · see citing works
“Rights-based justice requires that people’s basic human rights be respected [72].”
BackgroundGreenhalgh, T., Rosen, R., Shaw, S. E., Byng, R., Faulkner, S., Finlay, T., Grundy, E., Husain, L., Hughes, G., Leone, C., et al. (2021) · Frontiers in Digital Health · doi:10.3389/fdgth.2021.726095 · Cited by 173 · see citing works
“These principles were originally proposed by Beauchamp (who leant toward a consequentialist or utilitarian position, focusing on outcomes of decisions for the patient and others) and Childress (a deontologist focusing more on the clinician’s duties) (85), and extended to consider scope of application by Gillon (86).”
BackgroundGillon, R. (2015) · Journal of Medical Ethics · doi:10.1136/medethics-2014-102282 · Cited by 124 · see citing works
Self-citationSchleedoorn, M. J., Mulder, B. H., Braat, D. D. M., Beerendonk, C. C. M., Peek, R., Nelen, W. L. D. M., Van Leeuwen, E., Van der Velden, A. A. E. M., & Fleischer, K. (2020) · Human Reproduction · doi:10.1093/humrep/deaa007 · Cited by 43 · see citing works
Authoritarian versus responsive communitarian bioethics
Etzioni, A. (2011) · Journal of Medical Ethics · doi:10.1136/jme.2010.037846 · Cited by 37 · see citing works
Ethical Issues and Artificial Intelligence Technologies in Behavioral and Mental Health Care
Luxton, D. D., Anderson, S. L., & Anderson, M. (2016) · Artificial Intelligence in Behavioral and Mental Health Care · doi:10.1016/b978-0-12-420248-1.00011-8 · Cited by 36 · see citing works
Risks from Language Models for Automated Mental Healthcare: Ethics and Structure for Implementation
Grabb, D., Lamparth, M., & Vasan, N. (2024) · doi:10.1101/2024.04.07.24305462 · Cited by 40 · see citing works
DNR and COVID-19: the ethical dilemma and suggested solutions
Sultan, H., Mansour, R., Shamieh, O., Al-Tabba', A., & Al-Hussaini, M. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.560405 · Cited by 28 · see citing works
Vissers, M. F. J. M., Cohen, A. F., Van Gerven, J. M. A., & Groeneveld, G. J. (2021) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14480 · Cited by 25 · see citing works
- Authors
- Gillon, R.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Gillon, R
- ORCID
- Gillon, R
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1994-07-16
- Volume
- 309
- Issue
- 6948
- Pages
- 184
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2540719
- OpenAlex
- W2120229733
- Cited by
- 1,107
- References
- 4
- Citations by year
- 2026: 43 · 2025: 61 · 2024: 62 · 2023: 52 · 2022: 85 · 2021: 92 · 2020: 74 · 2019: 62 · 2018: 58 · 2017: 42 · 2016: 39 · 2015: 53 · 2014: 48 · 2013: 47 · 2012: 31
- FWCI
- 17.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical and Health Sciences Research
- Keywords
- medical ethics, respect for autonomy, beneficence, non-maleficence, justice, scope of application, ethical decision-making, health care ethics
- MeSH terms
- Decision Making, Delivery of Health Care, Ethics, Medical, Humans, Morals, Patient Advocacy, Personal Autonomy, Beneficence, Bioethical Issues, Value of Life, Principle-Based Ethics, Ethical Theory, Moral Obligations, Resource Allocation
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