**5. Analytical levels of bioethics**

There are four analytical levels to which bioethical principles are applicable. Each of these has its specific orientation and may or may not be related to the others. Microethical analytical level applies to relationship between individuals and in this case the health care provider and the patient, while the medical practitioner has an ethical obligation to give his patient enough and correct information on all available options to make an informed decision and consent, the patient is obligated to respect his or her medical practitioner's right to conscientious objection to any treatment being requested of him. For example, a medical practitioner's conscientious objection to induced abortion should be respected just as much as the medical practitioner is obligated to refer such patient to where competent treatment can be accessed. Macroethical level of bioethical analysis refers to the relationship between groups or communities – between members of the group of communities themselves, or between them and members of another group or community, for example, the ethical commitment to the provision of healthcare between an urban and rural population, or between different socio–economic classes of people within a group or community. Mesoethical analytical level otherwise known as ethics of intergenerational justice refers to discordance in resource allocation between groups by health managers at both public and private levels. Mesoethics falls between microethical and macroethical levels and implicates the ethical principles of beneficence and distributive justice, for instance contrasting high budgetary allocation to Senators to receive free medicare abroad even for trivial illness treatable locally, to the very low budget allocated to maternal health service delivery, in a developing country with unacceptably high maternal mortality. Megaethical level of bioethical analysis applies to issues operating beyond national boundaries, for example ethical issues related to the treatment of HIV/AIDS with Anti Retroviral Drugs where in the past the drugs are produced at reasonable cost in developed countries and exported to developing countries with a high burden of HIV disease and sold at prohibitive prices. Similar concerns are also manifest in reproductive health issues, and the effect of environmental pollution or degradation.
