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ARTICLE |

Ethical Principles in Critical Care

John M. Luce, MD
JAMA. 1990;263(5):696-700. doi:10.1001/jama.1990.03440050090040.
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THE MOST compelling principle of medical ethics always has been beneficence: acting to benefit patients by sustaining life, treating illness, and relieving pain. A correlative principle is nonmaleficence: refraining from harm. A third principle that has increasingly gained acceptance in the United States is autonomy: respecting the right of patients to determine much of their medical care. Closely related to this is disclosure: providing adequate and truthful information for competent patients to make medical decisions.1-3 A fifth ethical principle is social justice: allocating medical resources fairly and according to medical need.4

The first four ethical principles outlined above are the foundation of the fiduciary relationship in which physicians are expected to serve the best interests of their patients as the patients define these interests. This relationship is relatively easy to maintain when primary physicians follow up patients in their offices or in hospital rooms. However, the relationship may

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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