Table 1

Duties of a Physician Working in Different Roles as Described by Dialectical Principlism

Forensic RoleTreatment RoleResearch RoleAdministrative Role
Primary Societal ValueAdvancing justiceAdvancing patient welfareAdvancing scientific knowledgeAdvancing distributive justice
Proximal DutiesTruth-tellingRespect for personsRespect for autonomyBeneficenceNonmaleficenceFoster internal and external validity of experimentsAllocation of resources for maximal good in the system
Distal DutiesConsideration of the evaluee’s welfareConsideration of the retaining attorney’s caseConsideration of societal expectations for physiciansConsideration of personal valuesProtecting vulnerable third partiesDistributive justice and other societal considerationsConsideration of employer or organizationConsideration of personal well-being or safetyConsideration of the research subject’s welfare via: Fair subject selection Favorable risk-benefit ratio Safety Informed consent Respect for personsConsideration of welfare of the individual patient receiving care via: Autonomy Beneficence Nonmaleficence