It then tests whether the principles are predictive of ethical judgements. This study develops a measure of the medical ethical principles using the Analytic Hierarchy Process (AHP) as a methodological tool. Whatever the case, the scope for further investigation is large, and given the importance of medical ethics and understanding ethical outcomes in the medical sphere, it is also of considerable academic and clinical importance. This may be because of the difficulty associated with the quantification of the principles and/or the focus on more practical and case specific goals. Specifically, empirically establishing the worth of the principles as a descriptive and explanatory framework has received minimal academic attention.
However, given their dominance as an approach to medical ethics surprisingly little work has been conducted on the empirical importance and merit of the principles for individuals. Whilst they have received some criticism, predominantly from the casuists (the other main method adopted in bioethics) they are still widely used and discussed, even despite their limitations, both in practice and in the academic literature. Since their introduction by Beauchamp and Childress they have been the dominant approach to the teaching and evaluation of medical ethical dilemmas in health care. There is no denying the impact and importance of the medical ethical principles in medical ethics, or the high esteem in which they are held - as the quote from Gillon illustrates. “But I think the four principles should also be thought of as four moral nucleotides that constitute the moral DNA - capable alone or in combination, of explaining and justifying all the substantive and moral norms of health care ethics and I suspect of ethics in general”, p.308 The limitations of the principles in predicting ethical decision making are discussed. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. On average, individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas. This technique provides a useful tool in which to highlight individual medical ethical values. Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants who then made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation. The Analytic Hierarchy Process was used as a tool for the measurement of the principles.
This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas. The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care.
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