Principles of Medical Ethics

Beneficence and

Nonmaleficence

• Providing benefits

• Benefits and values

• Kinds of benefits – Health

– Wealth

– Aesthetic

– Professional

– Educational

Healthcare providers have the duty to

*do good* and *avoid harm* to their patients.

Health vs. Other Benefits

• The perspective of the healthcare provider:

* Maximize the health of the patient *

vs.

• The perspective of the patient:

* Maximize the overall well-being *

The Enhancement Debate

• Non-medical benefits from

medical treatment

• Physical enhancement

– Athletics

• Cognitive enhancement

– Pharmacological enhancement

• Aesthetic enhancement

– Plastic surgery

Benefits vs. Harms

• When high benefits come with high

risk, we have the following options:

1. Calculate the “net” good

2. Maximize the ratio between benefit

and harm

3. Nonmaleficence overrides

beneficence

Calculate the “net” good:

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Course of Treatment 1 Course of Treatment 2

Estimated Harm

Estimated Benefits

* (4 – 2) > (2 – 1) * Therefore, Course of Treatment 2 is to be preferred to Course of Treatment 1.

Maximize the ratio between

benefit and harm

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Course of Treatment 1 Course of Treatment 2

Estimated Harm

Estimated Benefits

* (2/1) = (4/2) * Therefore, Course of Treatment 1 is equally beneficial to Course of Treatment 2.

Nonmaleficence overrides

beneficence

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Course of Treatment 1 Course of Treatment 2

Estimated Harm

Estimated Benefits

* 1 < 2 * Therefore, Course of Treatment 1 is to be preferred to Course of Treatment 2.

Benefiting Others

• Benefits to society

• Benefits to specific non-patients

• Benefits to the profession

• Benefits to the health

professional and the health

professional’s family