A criticism and reappraisal of biomedical principles through the phenomenology of the physician-patient relationship

Abstract

Economic, social, legal, and political factors have combined In recent years to effect major changes in medical practice and health care policy. Concern for patient rights and patient autonomy have transformed the practice of medicine. The practice of medicine rooted In the doctor-patient relationship. Central to the arguments of the physician-patient relationship and to moral choices in health· care in general are the four principles put in a theoretical framework by Beauchamp and Childress : Beneficence (the obligation to provide benefits and balance benefits against risks), Non-Maleficence (the obligation to avoid the causation of harm), Respect for autonomy (the obligation to respect the decision-making capacities of autonomous persons), and Justice (obligations of fairness In the distribution of benefits and risks). Rules for health care ethics can be formulated by reference to these principles together with other moral considerations, although these rules cannot be straightforwardly deduced from such principles because additional specification and interpretation would be needed.