Principalism, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values.

How would you rank the importance of each of the four principles? How do you believe they would be ordered in the context of the Christian biblical narrative?

First, I must address what each of the four principles are.

1. Autonomy-agreement to respect another's right to self-determine a course of action; support of independent decision making (Beauchamp & Childress. 2009).

2. Beneficence- compassion; taking positive action to help others; desire to do good; core principle of our patient advocacy (Beauchamp & Childress. 2009).

3. Nonmaleficence- avoidance of harm or hurt; core of medical oath and nursing ethics (Beauchamp & Childress. 2009)

4. Justice- refers to an equal and fair distribution of resources, based on analysis of benefits and burdens of decision. Justice implies that all citizens have an equal right to the goods distributed, regardless of what they have contributed or who they are. (Butts &Rich, 2008).

In my opinion, Beneficence is the most important principle. Most ethical theories have embraced various aspects of beneficence, and utilitarian theorists see beneficence as the foundation for causing the greatest benefit for all.

If one is to take a positive action to help others and has the core principle to advocate what is good and just for others then the other principles seem to fall into place. Beneficence strives for the best care while embracing not doing anything harmful (Enright & Miyamoto, 2008).

If one acts in beneficence then it stands to reason that they would respect the persons autonomy, they would do no harm and justice would be maintained. How would I rank each? beneficence, followed by autonomy, nonmaleficence and finally justice.

In biblical terms, I feel that beneficence would again, be the most important principle. The reason I feel this way is because God gave his only son, for our benefit. Jesus died on the cross for our benefit. Everything that God and Jesus has done has been for the benefit of mankind. It is well known that in the bible, Matthew 25:36, states, I was naked, and you clothed me.

I was sick, and you visited me. I was in prison, and you came to me.' I feel that God wants how we live to benefit others. Everything we do in our lives affects another person one way or the other. It is up to us to have it be a positive benefit to others.

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