Cornerstones of Medical Ethics

• Autonomy (self-determination)
  
• Beneficence (doing good)
  
• Non-malificence (not doing harm)
  
• Justice (fairness and equality)

Important Concepts that Guide Ethical Decisions in Critical Care

• Human rights—the right to life: There are different views on whether life must always be sustained in all circumstances but there is a general view that life must be respected and not harmed. There are some situations where the vast majority of people would agree that prolonging life at all costs is wrong (such as following diagnosis of brain death) and the law will support a decision to stop treatment and allow death to occur.
  
• Acts of commission and omission: The difference between a decision that actively ends life and a decision to withhold or discontinue intervention that is prolonging life
  
• Quality of life: Most people believe this is important and is significantly impaired if:
  
  
  
  • life is dependent on invasive medical support
    
  • there is chronic distress
    
  • there is severe impairment of consciousness.