IMPORTANT GLOSSARY IN ETHICS
This glossary provides definitions for common concepts, principles, and values in health ethics.
For many of the terms, a number of definitions are available. This glossary is therefore not
intended to be definitive, but to aid understanding of common terminology, in particular as
used in this document Concept, principle or value
Definition
Accountability for reasonableness - Framework that requires that the rationale or reasons
underlying health-care-limiting decisions be made publicly available. Moreover, “fair-minded”
individuals – those who seek cooperation with others on mutually justifiable terms – must
agree on the applicability of these reasons to health care delivery in resource-constrained
settings (18).
Autonomy - Most often taken to refer to the ability of an individual to be his or her own
person, to make his/her own choices on the basis of his/her own motivations, without
manipulation by external forces. However, others in a more Kantian tradition see autonomy as
being firmly related to accepting and acting on the basis of one’s obligations, i.e. acting
morally, the precise opposite of doing what one wants (19, 20).
Beneficence - Principle requiring that governments, health care providers, and researchers do
good for, provide benefit to, or make a positive contribution to the welfare of populations,
patients and study participants (21).
Bioethics - The field of enquiry that examines ethical issues arising from the “creation and
maintenance of the health of living things”. Bioethics is much broader than medical ethics, and
includes all ethical issues in medicine, the life sciences and biomedical research (2).
Confidentiality - The obligation to keep information secret unless its disclosure has been
appropriately authorized by the person concerned or, in extraordinary circumstances, by the
appropriate authorities (15).
Dignity - A term used to suggest the idea of human worth or value. It is often used to link to the
idea of persons as being of value. “The notion of dignity is used to mark a threshold, a kind of
respect and care beneath which the treatment of any human being should never fall” (22).
Distributive justice (see also Equity)- A set of principles that provide “moral guidance for
political processes and structures that affect the distribution of economic benefits and burdens
within societies”. It is generally thought to be difficult, if not impossible, to distribute health.
However, there are a number of factors that may be considered relevant to the just distribution
of health (including income, wealth, utility), the number of possible persons involved
(individuals or groups), and differences in how the distribution should be made (equality,
maximization, etc.). Egalitarianism is one example of a distributive justice principle (23).
Glossary of terms:
Egalitarianism - A belief in equality. However, egalitarians disagree about what it is that should
be equal, for example whether people are entitled to equal opportunities, an equal share of
resources, or whatever level of opportunities and resources are necessary to generate equal
results .
Equity (see also Distributive Justice)
Equity - focuses on equal outcomes and this may require an unequal distribution of some good
to bring about the equal outcome. Health equity requires responding to “differences in health
which are not only unnecessary and avoidable but, in addition, are considered unfair and
unjust”
Ethics - Branch of knowledge concerned with questions about right versus wrong conduct and
what constitutes a good or bad life, as well as the justificatory basis for such questions.
Human rights - Fundamental freedoms and rights enshrined in a set of universal legal
statements. Some of the most important characteristics of human rights are that: they are
acknowledged in international declarations; states and state actors are obliged to respect them;
they cannot be waived or taken away (although the enjoyment of particular human rights may
be limited in exceptional circumstances); they are interdependent and inter-related; and they
are universal.
Informed consent - Agreement to a certain course of action, such as treatment or participation
in research, on the basis of complete and relevant information by a competent individual
without coercion.
Justice - A highly contested concept that can, roughly, be thought of as giving people what they
deserve. See also: Equity and Distributive justice.
Liberty - A highly contested and complex concept that is often presented as freedom from such
things as the interference, influence, or control of others. However, other accounts of liberty
focus on authenticity, self-realization, or even appropriate relations with others.
Non‑maleficence - A principle requiring that health care providers and researchers do not
inflict undue harm, either intentionally or through negligence.
Principle - A broad but fundamental norm which can provide justification for more specific rules
or standards. For example, it is often claimed that informed consent (a standard) is necessary
because of the need to respect autonomy (a principle).
Privacy - seeks to protect a person from scrutiny by others. Respect for privacy implies that
a person should not be expected to share personal information unless they so choose. Any
violation of privacy requires ethical justification although it might be outweighed by other
considerations in some cases (i.e. for the protection of the common good).
Procedural justice - Discussion of the values and processes necessary to bring about a just
outcome. For example, where resources are scarce and rationing is needed, a procedurally just
outcome would provide clear and justifiable reasons for the decisions made.
Proportionality - The balancing of the positive features and benefits of a particular
intervention, policy, or research study against its negative features and effects, when deciding
whether or not to implement it.
Public good - A commodity or service that meets the following two criteria: it is practically non-
excludable (i.e. no one can be excluded from consumption, irrespective of individual
contributions to provision) and non-rival (i.e. consumption by some does not reduce the
benefits of consumption accrued by others). For example, the eradication of smallpox counts as
a public good because it meets these criteria.
Public health ethics - The field of enquiry that examines ethical issues and dilemmas relevant to
the protection and promotion of population health and the collective actions necessary to
achieve these aims.
Reciprocity - A principle that focuses on “providing something in return for contributions that
people have made”. In some cases this can be a strict matching between an action, such as
participation in research, and compensation for any harm caused. In other cases, reciprocity
may be less direct and involve more general contributions for the benefit of others or society in
general.
Social justice - A concept focused on the root causes and existence of inequalities in society and
the need to explicitly address them. In some cases, this may require a redistribution of
resources to compensate for existing inequalities and further actions to prevent their
perpetuation.
Solidarity - A social relation in which a group, community, or nation stands together. It is often
appealed to in discussions about justifications for the welfare state or shared risks through
insurance pooling, and in thinking about how states might defend the interests of vulnerable
groups within their population.
Utilitarianism - A set of theories centred on the principle of utility which is often taken to
require that any action should maximize benefits for the greatest number of people.
Value - Concept that is “used to explain how and why things matter. Values are involved
wherever we distinguish between things as good and bad, better or worse.” Values are central
to ethical judgments. Often, the place to start in a discussion about what ought to be done is to
make clear what values are most relevant and what weight should be attached to them.
