This article discusses the inadequacy of the "four principles" framework in medical ethics and the need for care ethics, particularly in the provision of healthcare to vulnerable populations. The authors argue that the dominant framework of principlism, which focuses on autonomy, beneficence, non-maleficence, and justice, is insufficient in addressing ethical dilemmas in medicine. They propose that an ethics of care, as outlined by Joan Tronto, provides a more comprehensive understanding of moral practice, emphasizing attentiveness, responsibility, competence, and responsiveness. The authors also highlight the importance of Indigenous voices in healthcare institutions and the need for systems to be responsive to the values and interests of marginalized groups. [Extracted from the article]