Ethical principles in end-of-life care

The four pillars of medical ethics – autonomy, beneficence, non-maleficence and justice – provide a clinical framework for decision-making. Usually the patient has capacity for making decisions based on being given accurate information in a format that is understandable and applicable to their situation. The Mental Capacity Act 2005 has created a legal framework for decision-making when people may lack capacity. Capacity may fluctuate, may be partly impaired and must be carefully assessed when all efforts to support a person to make their own decision have failed.