The Principles of Bioethics Applied in Emergency Room

Abstract

Background: The authors carry out an ethical analysis of medical
decisions in the emergency service, based on the principles of bioethics:
autonomy, beneficence, non-maleficence and justice.
Material and Methods: A cross-sectional study was conducted
through a questionnaire survey to 68 doctors of general urgency. The
questionnaire consisted of fifteen clinical cases typified.
Results: A total 98.5% of respondents respected the right to revelation
of truth. Complied with the principle of beneficence 79.4% of respondents
and 30.9% agreed not to reveal the truth if it implied a psychological
threat to the patient respecting the principle of non-maleficence.
When two patients required mechanical ventilation, 66.2% of surveyed
doctors agreed with the non-discrimination by age, respecting the
principle of justice.
Discussion: Most doctors respected the dignity, autonomy and the
need to be warned of the risks by informed consent. Most considered
the patient's welfare, acting in the sense of the greater good. It is the
doctor’s duty to search for effectiveness and efficiency in strict management
of resources while respecting the principle of justice, without
forgetting that aggressive medical treatment may be inhumane and
undermine the dignity, violating the principle of non-maleficence.
Conclusion: Most doctors complied with the principles of dignity,
autonomy and beneficence. The non-maleficence and justice issues
generated controversy, since they are in conflict with the principles of
autonomy and beneficence. Doctors must take their decisions in full
freedom, respecting the autonomy of the human being and providing
benefit to health. It is also their duty not to cause intentional harm or
damage to the patients, acting responsively with the resources at their
disposal in order to provide health.