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General bioethical principles, such as autonomy, nonmalfeasance, justice, and care, provide the foundation for ethical decision making in health care. Aspiring to uphold the ethical principles is a fluid process, based on advances in health care, social and cultural pressures, and applications of the principles both to specific clinical situations and policy making. In this paper, we review the principles and discuss their application in rehabilitation and in health care. We argue that rehabilitation psychologists have unique expertise to impact ethical decision making at all levels of social structure, and that rehabilitation represents a critical forum in which this role definition of psychologists manifests itself. In addition, the principles themselves, if given substantive meaning in their practical application, can and should drive adaptive legislation in support of rehabilitation and health care goals in developing ethical care alternatives.