Frédéric Pochard, MD, PhD; Marc Grassin, PharmD, PhD; Elie Azoulay, MD
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Pochard F, Grassin M, Azoulay E. Ethical Principles for Everyone. Ann Intern Med. 2001;134:1152. doi: 10.7326/0003-4819-134-12-200106190-00024
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Published: Ann Intern Med. 2001;134(12):1152.
TO THE EDITOR:
We support the Tavistock ethical principles described by Frank Davidoff (1). When used alone, the principles of beneficence, nonmaleficence, patient autonomy, and distributive justice are inadequate, particularly under challenge from technical and social advances. We believe that medical guidelines cannot anticipate each unique combination of patient, family, and medical condition. For example, intensivists are currently in a double bind, in a process that can lead to psychological crises: either promoting assault by continuing unwanted care for a patient, or promoting an alternative form of assault by forgoing care. The aim of crisis resolution is not to find a “good” rather than a “bad” alternative, but to promote the less disruptive alternative in a particular context.
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