ABSTRACT
Principles-based reasoning or principlism, as well as case-based reasoning, or casuistry, are both highly influential in the field of ethics and morality in healthcare decision making. There are four principles that are widely accepted as essential for morally appropriate patient care. Respect for autonomy, beneficence, nonmaleficence, and justice have emerged from centuries of religious, social, and cultural attention to religion and morality. The process of specifying and balancing the four principles is a crucial skill in the principles-based method of caring for patients. Critical thinking skills and self-reflective practices are essential tools for any clinician seeking to care appropriately for patients. There are three additional approaches to clinical ethics that need careful consideration if we are to create a comprehensive and ethically effective response to religious and spiritual concerns in the clinical setting. The chapter addresses these under the rubrics of narrative ethics, virtue ethics, and care ethics.
