The next principle of bioethics that is discussed is the concept of beneficence. The “principle of beneficence refers to a statement of moral obligation to act for the benefit of others” (Beauchamp and Childress 203). According to this statement, beneficence is all about acting positively toward creating benefits for others as opposed to the negative action of doing no harm as explained by the principle of nonmaleficence. With this in mind, there is another clear distinction between the two principles and that is “the rules of nonmaleficence must be followed impartially” while the “rules of beneficence need not always be followed impartially.” (Beauchamp and Childress 204). What this means is when it comes to nonmaleficence, every physician and healthcare professional has the obligation to not inflict harm on patients yet for beneficence, not every physician is obligated to provide beneficial aid to patients who need it. My question is why is it that all physicians are universally required to do no harm, yet not all physicians are required to “act for the benefit of others” and can even refuse to treat certain patients?
The concept of refusing to treat a patient directly contradicts with the principle of beneficence yet there are laws such as those within the American Medical Association which declare, “a physician shall in the provision of appropriate patient care, except in emergencies, be free to choose who to serve” (Hood). The AMA then went on to add to this decree that in the case of discrimination, the physicians’ right to refuse to treat is not allowed. Additionally, there have been other debates about physicians’ refusal to treat patients when not in the case of discrimination, which is why other reasons have been offered to justify this contradiction with beneficence. Some of these reasons are that there are a limited amount of resources so not everyone can be treated, the patient is seen as hostile, the physician’s personal religious beliefs contradict with the aid necessary, or the physician will be at risk (Hood).
The last reason explained by Hood of the physician being at risk is brought up by Beauchamp and Childress and is specifically described as “X’s [physician] action would not present significant risks, costs, or burdens to X,” and “the benefit that Y [patient] can be expected to gain outweighs any harms, costs, or burdens that X [physician] is likely to incur” (Beauchamp and Childress 207). Thus, there is a sensitive relationship established between the patient and the physician when dealing with treatment, so it is important to consider both sides of this relationship and how everyone is ultimately affected with the decisions made. Lastly, in light of my discussion, I believe as we begin to diverge into this new concept of beneficence, it is important to remember the previous concepts in which we have discussed that way we continue to question how they coexist with one another; without trying to understand the contradictions these principles have amongst each other, we will not be able to provide a moral balance in the new situations that arise.
Work Cited:
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford University Press, 2001.
Hood, Virginia L., “Can a Physician Refuse to Help a Patient? American Perspective,” http://pamw.pl/sites/default/files/pamw_06_hood_pogl_en.pdf.
Hi Laura
I very much enjoyed reading your blog post. Your points in distinguishing between non-maleficence and beneficence stands out and is very clear. There is definitely uncertainty and contradiction when it comes to refusing to treat patients. When you said in the end of the blog post about how we should understand previous concepts in class, I thought directly of moral status. Does moral status come into play when you talk about beneficence and who to benefit directly? Do those 5 theories of moral status that Beauchamp and Childress list coexist with why certain physicians refuse to treat certain patients? I know that the moral status theory of relationships explains moral status based on how a physician and their patient interact and the bonds that form between them. Could this in a sense play into why physicians have a sort of bias in terms of benefiting individuals? Or is it just a large cost-benefit, harms, ratio that you talked about?
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford University Press, 2001.
Laura,
I really enjoyed your ideas on the difference between beneficence and nonmaleficence! However, I do have a question for you regarding your post. You said that “not every physician is obligated to provide beneficial aid to patients who need it.” I am curious as to whether or not you think that physicians are ever truly obligated to act to benefit a patient. Today in class (3/13) we discussed whether or not anyone should feel obligated to help a stranger or even a loved one. In my opinion, a physician should feel obligated to help his patients as it is his duty as a health care professional. On the other hand, I do not think that a normal human with no first aid knowledge is ever obligated to help another individual. Instead, I believe that they are morally inclined to act and as compassionate human beings we hold individuals accountable in such situations, but they are never under any obligation to act.
I think Peter Singer puts it nicely when he says “if it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral importance, we ought, morally, to do it.” I think that while no individual, besides health care professionals, are obligated to act in any medical situation, if they have the power to help an individual with little to no cost to themselves, they should.
Morgan Brandewie
Works Cited:
Singer, Peter. “BBC – Ethics – Charity: Peter Singer: It’s Our Duty to Give.” BBC News. BBC, n.d. Web. 13 Mar. 2017.
Hi guys,
Thank you for your comments! In response to your questions and ideas, I too agree that all medical professionals should have the obligation to help patients who need the care, yet there are situations in which some patients are not aided to the full extent as others. These cases provide unsettling feelings for those of us who are on the outside of the situation but for the healthcare professionals, the situation is viewed objectively and often according to cost-benefit analysis. As Beauchamp and Childress explain, institutional review boards (IRB) are often consulted when dealing with both treating patients and approving research using human subjects and “they typically use informal techniques such as expert judgments based on reliable data and analogical reasoning based on precedents” (Beauchamp and Childress 230). This explains how there is a specific procedural practice behind the decisions made with regards to treating patients that does not just take into account the beneficence of one patient but rather considers the future patients to come who may be in more critical conditions than the ones at hand. Thus, though it would be best if all physicians could aid every single patient, that is simply never going to be the case since there is only so much that can be done before the helping turns into hurting for both this one patient and the future ones.
Work Cited:
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford University Press, 2001.