Social Sciences, Ethics & Systems-based Practice

Autonomy — a patient with decision-making capacity has the right to refuse any treatment, even one that is life-saving, provided the refusal is informed and voluntary.

Autonomy (respecting the patient's right to self-determination), beneficence (acting in the patient's best interest), non-maleficence ("first, do no harm"), and justice (fair distribution of benefits, risks, and resources).

Beneficence is the positive duty to act for the patient's benefit and promote well-being; non-maleficence is the duty to avoid causing harm ("primum non nocere"). Most clinical decisions weigh the two against each other.

Justice — the fair, equitable distribution of scarce benefits, burdens, and resources, typically using objective, transparent criteria rather than favoritism.

(1) Decision-making capacity, (2) disclosure of the diagnosis, nature of the intervention, risks, benefits, and alternatives (including no treatment), (3) patient understanding, and (4) voluntariness (no coercion).

Emergency (implied consent when a patient cannot consent and delay would harm them), waiver (patient voluntarily declines to be informed), lack of capacity (use a surrogate), and the therapeutic privilege (rare; withholding info that would itself seriously harm the patient). Public-health mandates are a separate legal carve-out.