Both non-maleficence and beneficence are concepts that are universal across our world, whether it is in everyday actions or in a healthcare setting. However, to what extent is non-maleficence and beneficence universally recognized? We can analyze this question by delving into the motives and virtues of multiple cultures across the world and we can compare and thus contrast the aspects of non-maleficence and beneficence.
As we can see across the United States and in most western countries, non-maleficence and beneficence across a health care setting derives from the relationship between the doctor and his/her patient. Across history, our doctor-patient relationship in the United States has changed towards greater respect for patient’s autonomy rather than a historically paternalistic ideology. There needs to be much more consent from the patient before any type of medical procedure is placed upon the patient. Even in bioethics class, we place the importance on the consent of the patient and the patient’s autonomous decision.
In the sense the word “beneficence” is a type of paternalism in which the doctor assumes what is beneficial towards the patient. In many other cultures beneficence is actually emphasized more than autonomy. There has shown to be correlations between the type of government and the power of beneficence over autonomy. Pellegrino and Thomasma’s article asserts that this could be as a result of many different factors, of which includes technology, religion, economy, and politics.
Accordingly, in Islamic medical ethics, there has been studies done on the works of Mawlana, a prominent Sufi theologian and philosopher, that showed that beneficence is prioritized over autonomy. We also see that religion is a major factor when considering the emphasis of beneficence with Confucianism in China. Beneficence is emphasized greatly as “A humane art, and a physician must be loving in order to treat the sick and heal the injured” (Kao, 2002). Politics also play in a major role when considering beneficence. The world’s “democratization” carries with it distrust for authority, and thus there seems to be a correlation between the United States of America’s democratic politics and the lowered respect for paternalistic beneficence of the physician in most healthcare settings. Technological advancements in our society is also something that can be greatly considered when thinking about autonomy versus beneficence. Technology in a sense brings about freedom within people. Having different cars, phones, and other forms of technology allows us to assume that we are autonomous beings who have great power in our own decisions. This in turn seems to be correlated with our western culture being more focused on autonomy.
Does looking into a cross cultural prospective of the principles and aspects of autonomy and beneficence in a bioethical lens helps us in a way? I would say that it helps us to generalize less about “an individual” and to realize that there are many complicated factors when considering balancing autonomy of the patient and beneficence of the physician. I would love to hear comments and thoughts about this topic.
Works Cited:
Pellegrino, Edmund. “The Conflict between Autonomy and Beneficence in Medical Ethics: Proposal for a Resolution.” Journal of Contemporary Health Law & Policy. N.p., n.d. Web. 12 Mar. 2017.
“Non-Maleficence and Beneficence.” The EIESL Project RSS. EIESL Project, n.d. Web. 12 Mar. 2017.
“Ethics – Definitions and Approaches – The Four Common Bioethical Principles – Beneficence and Non-maleficence.” Alzheimer Europe. Visual Online, n.d. Web. 13 Mar. 2017.
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York, NY: Oxford UP, 2001. Print.
Hi James,
Your discussion of the relationship between culture and autonomy is interesting. It brought to mind a segment of what I learned about in my human growth and development course: the consistent cultural differences in how individuals are perceived.
Japanese mothers, for example, view their infants as independent beings who must learn the importance of relationships and connections with others. Infants maintain close physical contact with their mothers, who encourage them to develop close ties and depend on their assistance. North American mothers, on the other hand, view their task as shaping babies into autonomous beings (Kojima, 1986). Japanese mothers tend to interact with their babies in soothing ways, discouraging strong emotions, whereas North American mothers are active and stimulating (Rothbaum, Weisz, Pott, Miyake, & Morelli, 2000).
Culture influences the behaviors that individuals view as desirable and the means that parents use to socialize their infants. Culture, therefore, plays a role in how development as an autonomous being unfolds; by inference, the emphasis on autonomy during development is greater in the North American culture than in the Japanese culture. Although this does not necessarily indicate that autonomy is of greater importance than beneficence in that culture, it does reveal the influence of culture on the perception of the individual person.
Works Cited
Kojima, H. (1986). Becoming nurturant in Japan: Past and present. In A. Fogel & G. F. Melson (Eds.), Origins of nurturance: Developmental, biological, and cultural perspectives on caregiving (pp. 359-376). Hillsdale, NJ: Lawrence Erlbaum.
Rothbaum, F., Weisz, J., Pott, M., Miyake, K., & Morelli, G. (2000). Attachment and culture: Security in the United States and Japan. American Psychologist, 55, 1093-1104.
Hi James!
I really enjoyed reading your post on the cultural perspectives of autonomy and beneficence. I definitely agree that in the United States, we seem to have a greater care for respecting autonomy compared to other cultures. However, the United States is considered the “land of the free”, so it should not be a surprise that autonomy carries a greater weight for us compared to other cultures. For example, in a culture, where men make all decisions and women have minimal rights, a female patient’s autonomy is most likely to not be of much value. I still believe that the principle of beneficence is incredibly important, but I feel privileged and lucky to grow up in a culture where the decisions I make about my own health are respected.
Another interesting point you bring up is the importance of religion in biomedical ethics. It is imperative that healthcare professionals have an understanding of how religions affects morality and the values of their patients (Turner, 2003). As we have previously discussed in the Jehovah’s witness case, religion plays a key role in what steps should be taken. While a blood transfusion goes against her religion, she will die without one (Thomas et al., 1987). A decision must be made, but what should hold more value, her religion and autonomy or the principle of beneficence? This balance between patient autonomy and beneficence are greatly affected by religion and must these decisions should be considered on a case by case basis.
Works Cited:
Thomas, John E, et al. Well and Good: Case Studies in Biomedical Ethics, Broadview P, 1987.
Turner, Leigh. “Bioethics and Religions: Religious Traditions and Understandings of Morality, Health, and Illness.” Health Care Analysis 11.3 (2003): 181-97. Web.