Medical ethics: four principles plus attention to scope

BMJ. 1994 Jul 16;309(6948):184-8. doi: 10.1136/bmj.309.6948.184.


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.

Publication types

  • Review

MeSH terms

  • Beneficence*
  • Bioethical Issues*
  • Decision Making
  • Delivery of Health Care / standards*
  • Ethical Theory*
  • Ethics, Medical*
  • Humans
  • Moral Obligations*
  • Morals
  • Patient Advocacy
  • Personal Autonomy*
  • Principle-Based Ethics*
  • Resource Allocation
  • Value of Life