Health Care Analysis

, Volume 14, Issue 2, pp 111–117 | Cite as

Principles Help to Analyse But Often Give No Solution—Secondary Prevention after a Cardiac Event

  • Lars WestinEmail author
  • Tore Nilstun
Original Paper


The aim of this paper is to investigate whether or not ethical conflicts can be identified, analysed and solved using ethical principles. The relation between the physician and the patient with ischemic heart disease (IHD) as life style changes are recommended in a secondary prevention program is used as an example. The principal persons affected (the patient and his or her spouse) and the ethical principles (respect for autonomy, non-maleficence, beneficence and justice) are combined in a two dimensional model. The most important person affected by the recommendations is the patient. His or her autonomy is challenged by the suggested life style changes, the purpose of which is to promote the future wellbeing and health of the patient. The spouse is indirectly involved in and affected by the process. He or she often feels neglected by caregivers. Ethical conflicts can both be identified and analysed using ethical principles, but often no solution is implied. Most (if not all) physicians would strongly encourage life style changes, but surprisingly there is no uncontroversial justification for this conclusion using principles.


Analysis Communication Ethical principles Ischemic heart disease Life style change 



Coronary artery by-pass grafting


Ischemic heart disease


Percutanous coronary intervention


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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of Medical EthicsUniversity of LundLundSweden

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