ArticleThe American journal of bioethics : AJOB2026
Principlistic Equality: The Relative Importance of the Four Principles Among Primary and Urgent Care Clinicians.
Article in The American journal of bioethics : AJOB, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Exploring primary care providers' perspectives on clinical decision support for venous thromboembolism diagnosis: a qualitative study.BMJ open · 2026Article
- Prioritising time for communication in healthcare-a normative analysis.Medicine, health care, and philosophy · 2026Article
- Yonder: Principlistic equality, rejected referrals, ruptured AAAs in out of hours, and Kickstart patient movement.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Principlistic equality, the idea that the four principles of bioethics should be considered as nonhierarchical in the abstract, is core to the original conception of principlism, but it is unclear whether clinicians endorse principlistic equality in practice. We surveyed 227 primary and urgent care clinicians (62.8% response rate), finding just over half of respondents (51.9%) endorsed a hierarchy among the principles. Among this group, non-maleficence was most often over-weighted (by 57.1% of these respondents), followed by autonomy (42.0%), justice (35.7%), and beneficence (34.8%). Practicing in a safety net setting (OR = 0.51, 95% CI = 0.27-0.96) and spending less than half of one's time in direct patient care (OR = 0.23, 95% CI = 0.09-0.58) were associated with significantly lower odds of endorsing principlistic equality. Several clinician characteristics were associated with giving additional weight to certain principles. Our findings provide insight into how clinicians value the four ethical principles, which could inform education and training initiatives in bioethics.
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Registered trials
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