Clinical ethics: Due care and the principle of nonmaleficence

In this thesis I argue that the moral dilemmas of clinical medical practice can best be resolved within a framework of prima facie duties, and that the most stringent of these duties is nonmaleficence. I contend that not only do health-care practitioners have a prima facie duty not to harm their patients but also that individuals who suffer from illness, injury, or disease have a duty not to bring harm to other members of the moral community or the community itself.;I argue that practitioners should know and understand their patients perceptions of illness and suffering and the life-plans and values of their patients if they wish to avoid bringing further harm to these patients. Additionally, I argue that the duty of nonmaleficence is best served and due care best provided to patients if the clinical relationship is defined within the framework of a covenantal agreement between the practitioner and the moral community.;In order that harms be minimized, I suggest that not only is it permissible to limit a patient's autonomous choice, it is sometimes obligatory to do so. Further, informed consent should be considered as something more than a right patients hold; it should be understood as a duty patients have. I argue that parentalistic interventions are not without justification if a community wishes to minimize harm to its members.;I argue that both respect for individual autonomy and beneficence are inadequate as primary or foundational principles for the moral practice of clinical medicine since simple adherence to either principle may be insufficient to the provision of "due care.";My examination of clinical medical ethics concludes with a defence of the principle of primum non nocere and an examination of how the exercise of specific virtues in the clinical relationship and the employment of a political conception of justice and a sense of responsibility can help a moral community implement the operation of nonmaleficence in clinical medical practice.