Medical ethical principles against the background of ‘European values’

Abstract

Medical ethics is a field of expertise that has developed alongside increasingly powerful technologies that have changed medical practice significantly over the past decades. From artificial ventilation and the possibility of resuscitation after cardiac arrest in the 1960s to the big-data-driven medicine of today, increasingly supported by artificial intelligence (AI), modern medicine is loaded with ethical dilemmas and complex decisions. Four principles, namely respect for autonomy, non-maleficence, beneficence and justice, were identified in the 1970s as guiding concepts of an ethics of biomedicine, the then emerging clinical practice that is informed by biological and physiological evidence from basic research. However, as the cultural and historical context affects the understanding of these principles, their implementation in clinical practice and healthcare is not trivial. Here, we highlight additional principles and values that back up these four core principles in the European context, particularly solidarity, human dignity, pluralism, tolerance, non-discrimination and gender equality. We further summarize how European Union law reflects such principles and values, and refer to existing instruments to support their implementation. Focusing on solidarity, we highlight its understanding in the European context and some challenges for its realization, particularly in the context of using AI in medicine and healthcare.