COMMENTARY This essay is a very general one. There are quite a number of ways in which it could be tackled. You could seek to define the notions of autonomy, non-malfeasance, beneficence and justice; you could discuss whether they are the four great principles of medical ethics or whether there are others; you could discuss whether autonomy is the ‘first among equals’; and you could consider various scenarios to show how the different approaches lead to different responses. To deal with all of the potential issues would take a whole book. Spend some time preparing for a question like this. What realistically can you cover and what are you best prepared to discuss? At the start of the essay set out what issues you are going to address and what you cannot discuss.