The Four Principles

How would you rank the importance of each of the four principles? How do you believe they would be ordered in the context of the Christian biblical narrative? Refer to the topic study materials in your

The four principles approach to medical ethics are beneficence, non-maleficence, justice and respect for autonomy (Beauchamp, & Childress, 2013). This approach has become dominant ethical framework in healthcare settings. It is held that applying those principles to ethical dilemma can clarify ethical conflict and allow solutions to be found. However, that is not the case, they fail to provide direct solution to most ethical problems and they lack inherent moral weight (Hoehner, 2020).

I would rank the importance of these principles as follows, autonomy, beneficence, non-maleficence, autonomy and justice. Respect for autonomy is about respecting informed decisions of competent adult persons. It is about being respectful in treating and providing information that promote the ability to make autonomous decisions. “The prima facie priority of respect for autonomy can only be violated in the most extreme circumstances” (Hoehner, 2020). Respect for autonomy allows competent persons to make informed decisions based on their values and beliefs having being beware of the consequences of such decisions (Freer, 2017).  “A Christian worldview embraces the importance of respecting a patient’s autonomy, as long as it complies with the fundamental principles of the moral law, such as the sanctity of all human life and the mandate to not unjustifiably take an innocent human life” (Hoehner, 2020).

The principle of beneficence means acting in the best interest of others. I would rank beneficence second because it is a moral obligation to benefit or help others. This principle require the person to act in a way that help or those with whom they have a special relationship with. The physician is obligated to balance benefits, burdens and risks of treatment decisions. The notion that the provider should create a plan of care that give the most benefit to the patient relative to other alternative is self-evident.

The principle of non-maleficence means the moral obligation not to cause harm on others. The medical act performed ought not to cause harm or pain. One is morally prohibited from inflicting unnecessary harm or injury in the course of treatment. The prince of justice requires treating similar cases alike and distributing the resources fairly.  It make sense that medical benefits ought to be allocated fairly and equally, so that patients in situation and with the same needs will receive fair treatment.

Principles of medical ethics are self-evident. By self-evident, one means that the principles must be fulfilled unless they conflict with an equal or much stronger principle (Hoehner, 2020). One limitation of these principles, however, is that they are too broad in their application such that they offer limited direct help when it comes to actual moral decision making. As a Christian, one can find a solution to these conflicts by drawing a wealth of moral resources, such as the Biblical narrative. I believe the order of importance for principles in the Christian biblical narrative would be as follows Justice, non-maleficence, beneficence and autonomy.

The usefulness of this principlist approach is limited in the sense that it lacks an internal hierarchy of the four ethical principles. As result, it is difficult to apply two or more conflicting ethical principles to solve an ethical problem, especially when they compete. This complex is further compounded by the fact they must be interpreted in the context of a particular worldview, ethical theory or philosophy (Hoehner, 2020).  The ultimate foundation of Christian ethics is the character and work of the triune God. The biblical narrative of creation, fall, redemption and restoration offer a rich perspective for the many ethical dilemma encountered in the world. The biblical narrative should provide guidance for choosing how best to address many of the challenging moral issues encountered in healthcare setting. The “Christian approach to virtue ethics is based on being made in God’s image with the purpose of glorifying God and enjoying Him forever” (Hoehner, 2020). This approach identifies three aspects of ethical reflection, which are the Christian’s character and motive as often informed by God’s love, the character of God as mirrored in his commands, and the goal of Christian living (Hoehner, 2020).  The two greatest commands taught by Jesus is to love God with all your soul and strength, and to love my neighbor. To love my neighbor implies treating my neighbor fairly, justly and with charity. All humans are created in God’s image, have value and dignity and thus must be treated fairly. Justice advocates for the disadvantaged and poor who may be not treated fairly. That is why the principle of justice is important.  Next in order of importance is non-maleficence, a moral obligation not to harm others. The intrinsic value of human being forbids one from harming another.


Freer, M. J. (2017). Autonomy in Applied Medical Ethics. Ethics & Medicine 33 (1), 21,

Beauchamp, T.L. & Childress, J. (2013). Principles of biomedical ethics. New York: Oxford University Press.

Hoehner, P. J. (2020). Biomedical Ethics in the Christian Narrative. In GCU, “Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care.” Retrieved on March 15, 2021 from

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