Ethics & Law · patient case question
Which ethical principle is most directly upheld by this consent process?
Patient case: Consent Across Three Patients
Patient: 39-year-old male, plus two additional patients seen the same day
Chief Complaint: “My wisdom tooth on the bottom left is broken down and I want it out.”
Background: Patient A: 39-year-old male, healthy, no medications, no anticoagulant or antiplatelet therapy, no allergies. Tooth #17 grossly carious and non-restorable. Risks, benefits, and alternatives to extraction were discussed in full; he asked questions, expressed understanding, verbally agreed, and signed the consent form. Patient B: 5-year-old male attending with his mother for restorative treatment. Patient C: 44-year-old male rendered legally incompetent following a gunshot injury to the head; his wife has been appointed his legal guardian by the court.
Medications: Patient A: none
Vital Signs: Patient A: BP 120/76 mmHg · HR 72 bpm · RR 16 · T 98.6°F
Findings: Patient A: #17 with gross distal caries extending subgingivally, non-restorable. No pericoronitis, no trismus, no lymphadenopathy.
Show answer and explanation
Correct answer: B. Autonomy
- A. Incorrect. Justice concerns fairness in the distribution of care and resources, and equitable treatment of patients. It is not the principle engaged by an individual consent discussion.
- B. Correct. Autonomy is the patient’s right to self-determination. Informed consent is the practical mechanism by which that right is honored, ensuring decisions about his own body are made by him on the basis of adequate information.
- C. Incorrect. Nonmaleficence is the duty to do no harm. It governs technique, competence, and avoidance of unnecessary risk rather than the decision-making process.
- D. Incorrect. Beneficence is the duty to act for the patient’s benefit. It underlies the recommendation itself, but the consent process specifically protects his right to accept or refuse that recommendation.
Note: The five principles in the ADA Code: autonomy (self-governance), nonmaleficence (do no harm), beneficence (do good), justice (fairness), and veracity (truthfulness).