Ethical Issues - Principals For Decision Making
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Autonomy | Beneficence and Non-maleficence | Justice
Autonomy
- Principle of self-determination
- As an individual right it may have to be balanced against the rights of others and is therefore not absolute.
Essential to the maintenance and achievement of autonomy for individuals using genetics services are:
- Information and counselling
- Consent
Beneficence and Non-maleficence
primum non nocere - above all, do no harm
Beneficence and non-maleficence are subjective terms. Given the shared implication of genetic inheritance and genetic conditions, what is to the good of one individual may result in harm or disadvantage to another. Inevitably, there must be a balance of responsibility to the individual, the family and the public good.
Practically all interventions by health care professionals have a capacity to cause harm. Health care professionals have to exercise judgement as to whether any particular intervention is justified by the balance of potential benefit and potential harm. They must maintain and employ high levels of professional skills, knowledge and attitudes.
Some harmful outcomes arise from obvious cases such as failure to perform a surgical procedure with due skill and care, prescribing the wrong medication for an illness or conveying the incorrect information. Some causes of harmful outcomes may be less obvious.
Justice
- Fair, equitable and appropriate treatment
- Respect for people with disabilities
- Recognise the intrinsic value of individuals regardless of their genetic condition
- Acknowledges that provision of testing to enable the avoidance of a particular genetic condition does not devalue persons with that condition
- Acknowledges the need for support for people with genetic conditions and for those making difficult
decisions concerning the avoidance of a particular condition - Respect for a patient's or a family's decisions
- Recognises that informed understanding and autonomy should underpin a patient's decisions
- Accepts that individuals are free to decide whether or not to make use of facilities
- Accepts that opinions should be put in a non-judgmental way and choices supported
- The allocation and distribution of limited resources to enable equity of access to services and
information regardless of:
- Place of residence
- Ethnicity
- Gender
- Religion
- Age
- Disability
