| Sumario: | The article examines the ethical framework guiding emergency medicine, emphasizing that the four principles of biomedical ethics—non-maleficence, beneficence, autonomy, and justice—must be weighted differently in this clinical context due to its unique temporal pressures and patient vulnerabilities. It argues that non-maleficence (avoiding harm) and beneficence (actively promoting health) take precedence during acute emergencies where rapid decisions are necessary, often limiting patient autonomy temporarily. Autonomy is respected through advance directives, surrogate decision-making, and restored once patients stabilize, while justice primarily functions at the systemic level via triage and equitable access mandates like the Emergency Medical Treatment and Labor Act (EMTALA). The article concludes that this context-dependent prioritization reflects sophisticated ethical reasoning rather than a rejection of principlism’s core architecture.
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