**12.3 Non-maleficence**

The ethical principle of non-maleficence is related to beneficence but they are different [44]. The principle of non-maleficence states that no harm should be done to the patient or other people in the community [4, 9, 10, 17, 48]. Implementing the principle of non-maleficence means that any treatment option that will be harmful to the patient should not be offered to the patient [44] as the patient will also exhibit autonomy. Hence the patient's medical condition may worsen. Violation of non-maleficence can lead to litigation and malpractice. Negligence is a consequence of the violence of non-maleficence. Medical error can result in non-maleficence. This also applies to research in which the research protocol must be reviewed by an institutional review board so that none of the research participants suffer harm. All the benefits, risks and consequences of all treatment are weighed in the course of the medical consultation [49]. It is the duty of the physician to protect their patients [48]. Though all health practitioners encounter ethical challenges in the course of their work, the principle of not to do harm is always a priority [17].

#### **12.4 Justice**

Justice requires fairness in the management of patients and distribution of resources especially in the time of scarcity and when priority needs to be maintained such as during mass casualty and pandemics. Individuals at all time should be treated fairly when they visit a health facility [10]. The distribution of health resources requires justice for it to be done fairly and equitably [1, 4, 19, 47]. Justice is also necessary in respecting the rights of patients [19]. In times of scarcity, the ethical principle of justice is used to determine areas of priority in the distribution of health resources [10].
