Why Medical Ethics Matter: A Guide for Pre-Med Students

Medicine is a high-responsibility profession. When making decisions that can impact a patient for life, physicians need to consider the ethical impact of their choices and actions. For pre-medical students like you, an understanding of the essentials of medical ethics is just as important as mastering biology or chemistry. Ethical decision-making is the foundation of patient trust, professional integrity, and quality healthcare. 

There are four widely accepted pillars of medical ethics: beneficence, non-maleficence, autonomy, and justice. This article walks through each one, and describes issues related to each pillar that you should be aware of as you launch your pre-medical education (or continue it with a post-bacc program).

Beneficence – The Duty to Do Good

Beneficence recognizes that a doctor’s first task is to act to improve the health of their patients. Beyond the exam room, beneficence can include acting as an advocate for patients or taking extra steps to ensure they can access treatment – for example, being willing to see patients who are shift workers out of your normal office hours.

Enhancing the well-being of those in your care is more complex than it sounds, however: if your patient is resistant to treatment or just a difficult person to deal with, how will you work to support their health? Beneficence requires you to do your best to find a way to support your patient.

Non-Maleficence – The Duty to Do No Harm

You may have heard the Hippocratic Oath many doctors take summed up as “First, do no harm.” This is based on an old translation of writings from the ancient Greek physician Hippocrates (460 – 377 BCE), who was the first practitioner to try to apply scientific reasoning and ethical standards to patient care. Non-maleficence is the ethical pillar that reflects this idea of doing no harm.

When making decisions, doctors must consider all outcomes of a treatment, such as whether an effective medication that has harsh side effects will cause too much suffering to a patient. The idea of non-maleficence often comes into play regarding end-of-life issues, such as when to pursue resuscitation or other heroic methods that could prolong a patient’s life while causing lasting damage. 

Autonomy – Respecting a Patient’s Right to Make Informed Decisions

Paternalism – assuming the doctor knows better than the patient and can make treatment decisions without their consent – was the model of healthcare for centuries. Today, medical ethicists recognize that physicians can inform, advise, and encourage patients to adopt a certain treatment, but not force them to do so. While ethical questions around privacy of patient data and a patient’s right to access their records relate to autonomy, the major issue is one of consent.

Patients have the right to make informed decisions about their care, and they must accept or decline certain treatment, even if their choices conflict with a physician’s recommendations. Balancing respect for autonomy with the physician’s duty to promote the best medical outcome is a frequent ethical challenge, especially when dealing with medical decisions made by parents on behalf of children, such as whether to vaccinate against childhood diseases.

Justice – The Duty to Treat All Equally

Justice is one of the most complex pillars of medical ethics. One of the major issues associated with justice in medical practice today is the issue of resource allocation, or “distributive justice”. Limited healthcare resources mean physicians must make difficult decisions about who receives certain treatments. Ethical considerations include fairness, prioritization of care, and addressing healthcare disparities between socioeconomic groups.

Developing Your Medical Ethics Mindset 

Ethical challenges are an inevitable part of medicine, but by cultivating ethical awareness early, you can prepare to navigate these dilemmas with integrity. Developing your ethical awareness requires reflection – some of these issues are rooted in centuries of philosophical writing and discussion – but it also requires action. 

Shadowing experienced physicians or gaining exposure to patient care through work experience and volunteering lets you engage with these ethical challenges at first hand. So too does learning how to become an advocate for patients early – even while you’re a pre-medical or post-bacc student yourself.