Medical Ethics in the Med School Admissions Process

Why Bioethical Principles Matter When Applying to Med School

When applying to medical schools, it’s critical to demonstrate comprehension of bioethical principles so that you increase your chances of not only getting accepted but also serving your patients well as a physician in the future.

The most important areas in which you’ll need to demonstrate your understanding of bioethics are your interviews, situational judgement tests (SJTs) such as Casper and AAMC PREview, and your secondaries.

I recommend outlining and editing your personal statement with bioethics in mind. Before you write it, figure out how to naturally demonstrate bioethical comprehension. After you write it, ensure your anecdotes honor bioethical principles.

Read Next: 18 Sample MMI Questions + How to Ace Your Interview

The 4 Principles of Biomedical Ethics

Biomedical ethics apply moral concepts to medical practice and research, helping healthcare providers make decisions that respect patient rights and ensure fair treatment.

Biomedical ethics is continually evolving, reflecting societal changes and advancements in medical technology.

How many ethical principles of medicine are there? Traditionally, there are four fundamental ethical principles of medicine: autonomy, non-maleficence, beneficence, and justice. These four principles (proposed by Tom L. Beauchamp and James F. Childress) provide a framework for the ethical decision-making process in healthcare.

1. Autonomy

The principle of respect for autonomy means that individuals have the right to make informed decisions about their own healthcare. Healthcare professionals must respect patients’ self-determination and permission, even if they disagree with the patient’s autonomous choice.

Of course, the patients must have the necessary understanding and mental capacity to make those directives. Autonomy involves respecting patients’ values, beliefs, and choices in the process of informed consent and truth-telling.

Example of autonomy: Respecting religious beliefs concerning blood transfusions. As long as the patient is of sound mind and grasps all the facts, the patient must be in control of the decisions.

2. Non-maleficence

Non-maleficence means “do no harm.” This principle asserts that healthcare providers have a duty to avoid causing harm to patients. In situations where harm cannot be entirely avoided, such as surgery, the potential benefits should significantly outweigh the risks.

Example of non-maleficence: Weighing the potential risks and benefits of treating a pregnant woman with cancer. Doing no harm to the pregnancy may interfere with the mother’s health, and a physician will need to discuss options with the patient.

3. Beneficence

Beneficence means “do good.” The principle of beneficence compels healthcare providers to act in the best interest of the patients. 

This principle can involve actions like providing treatment to improve health and alleviate suffering. It can even go beyond nonmaleficence, such as promoting actions to patients in preventive healthcare, like healthy lifestyle habits.

Example of beneficence: Holding a patient’s hand during end-of-life care before their family can get there. It’s about doing the “right” thing that is not necessarily required of you.

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4. Justice

In the context of biomedical moral theory, justice involves fairness and equality in medical care. It states that all individuals should have equal access to healthcare resources and receive equal treatment regardless of factors like race, gender, socioeconomic status, or health condition.

Underserved communities and non-English-speaking patients have generally worse health outcomes in the United States, and the principle of justice seeks to correct that inequity in various ways.

Example of justice: Equitably distributing limited resources to people who need those resources. For instance, as the COVID-19 pandemic took hold, doctors, nurses, and other healthcare professionals in New York grappled with complex moral justice problems, specifically who to give treatment and medical equipment when confronted by the harsh reality of limited resources.

Finding Balance When Principles Are in Conflict

As a physician, you will be faced with ethical problems, and the principles guiding your choices may conflict. Clinical ethics put your practical moral principles to the test.

For example, at times the moral justifications for a patient’s autonomy might conflict with a doctor’s intention for beneficence. Or limited resource allocation may cause non-maleficence to conflict with distributive justice.

In such cases, you must use personal judgment to balance these principles and find a solution that upholds the spirit of the biomedical code of ethics.

Many have argued for more specificity in these bioethical principles, as well as improved practical methods for resolving conflicts. Some critics dispute these “universally shared” moral norms in our healthcare system because of Western biases misrepresenting our diverse, multicultural world.

8 Examples of Biomedical Ethics Cases

Biomedical moral reasoning comes into play in various healthcare situations. Below are examples of biomedical ethics cases in more depth:

• Surgery Refusal — Principle of Autonomy: A patient might refuse a life-saving surgical procedure based on personal or religious beliefs. Here, the principle of autonomy comes into play. Healthcare professionals should respect the patient’s informed decision, even if it contradicts their own views about what would be most beneficial or least harmful to the patient.
• In-Vitro Fertilization (IVF) for “Healthier” Offspring — Principle of Justice: With the increasing use of IVF by fertile individuals for selecting “healthier” offspring, ethical dilemmas such as eugenics and the notion of “designer babies” emerge. Does this practice undermine the value of diversity and inclusivity in society?
• Euthanasia — Principle of Non-maleficence and Autonomy: Euthanasia raises questions about patient autonomy and the medical professional’s duty to “do no harm” to the patient (non-maleficence). While the American Medical Association (AMA) generally opposes euthanasia, states like Oregon have passed the Death With Dignity Act, allowing terminally ill adults to voluntarily request a prescription for lethal drugs.
• Mandatory Vaccination — Principles of Autonomy, Beneficence, and Justice: The ethical dilemmas surrounding mandatory vaccination for diseases like smallpox highlight the balance between individual rights (autonomy) and public health needs (beneficence and justice). Vaccination policies should balance the duty to protect public health (beneficence) and the fair distribution of health benefits/risks (justice) against individual rights to refuse medical treatment (autonomy).
• AI in Healthcare — Principle of Autonomy: As artificial intelligence (AI) assumes a greater role in healthcare decision-making, bioethical dilemmas arise. Questions of accountability, bias, confidentiality, and decision-making become prominent. For instance, who is responsible when AI makes errors? How can patient privacy be ensured while also using their data to improve AI algorithms?
• Organ Transplantation and Donation — Principles of Beneficence and Justice: The shortage of organs for transplantation and the subsequent development of black markets for organs is ethically complex. Issues like equitable access to organs and how to increase the organ donation rate are constant challenges. As a medical professional, how do you decide which patient gets an organ over another patient?
• Gene Editing for Genetic Diseases — Principles of Non-Maleficence and Justice: The rise of gene editing as a preferred therapeutic approach for genetic diseases brings its own ethical dilemmas. Questions about who gets access to these treatment options, the potential for unintended consequences, and the broader implications of changing the human genome are contentious. Should financial means or the potential harm to the human genome halt care using this method?
• Suicide Attempts — All Four Principles: Managing responses to suicide attempts requires being an ethical decision-maker. Physicians must balance respect for the patient’s autonomy with the duty to provide beneficial care, avoid harm, and account for inequities that may have contributed to the attempt. Involuntary hospitalization and psychiatric treatment could be seen as violating autonomy or justice but could be justified under the principles of beneficence or non-maleficence.

Additional Ethical Concepts

Beyond the four principles discussed, there are additional ethical concepts important in healthcare settings to be aware of as a prospective doctor:

• Paternalism is imposing decisions or restrictions on individuals, often without their consent, for their perceived benefit, which goes against the principle of autonomy. This approach is based on the presumption that the acting authority has a better understanding of what is best for the individual’s well-being. Paternalism may be acceptable, for instance, if a patient cannot provide consent in an emergency scenario, and a healthcare provider might intervene based on their professional judgment of what is in the patient’s best interest.
• Confidentiality is a key ethical principle that requires healthcare providers to keep all information about a patient’s health, including medical conditions, treatments, and personal details, private unless the patient gives explicit permission to disclose it. Outside of HIPAA’s legal protections, maintaining confidentiality not only falls under respecting autonomy, but it also helps to build trust. A trusting patient is more likely to share all the necessary information a doctor needs for effective treatment.
• Scientific validity in biomedical research is the degree to which a study accurately measures what it intends to measure. This ethical concept is fundamental to ensure that research is ethically acceptable and useful. Without scientific validity, research poses unnecessary risks to human subjects, wastes resources, and does not contribute valuable knowledge to the scientific community. It may also lower trust in scientific institutions. Ethical considerations of scientific validity include sound study design, appropriate methodology, accurate data interpretation, reproducibility and transparency, data integrity, and risk-benefit ratio.

Understand Bioethical Principles As You Apply to Med School

As a part of your medical school applications and interviews, you may be asked to discuss and analyze situations based on biomedical ethical principles. Remember, the key is not merely to recite these common morality principles but to demonstrate your own moral character.

Give the MedSchoolCoach Casper Preparation program a try. It includes a mini instructional course and two realistic, simulated Casper exams that mimic the actual test. You’ll aslo get a 45-minute feedback session with a Physician Advisor to ensure that your responses align withethical decision-making.

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