Beneficence (ethics)
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Beneficence in general means "active well-doing". Duties of beneficence form a part of various religious and secular ethical theories. As an applied ethical concept relating to
research Research is creative and systematic work undertaken to increase the stock of knowledge. It involves the collection, organization, and analysis of evidence to increase understanding of a topic, characterized by a particular attentiveness to ...
, beneficence means that researchers should have the welfare of the research participant as a goal of any
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
or other research study. The antonym of this term, maleficence, describes a practice that opposes the welfare of any research participant. According to the
Belmont Report The ''Belmont Report'' is a 1978 report created by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Its full title is the ''Belmont Report: Ethical Principles and Guidelines for the Protection o ...
, researchers are required to follow two moral requirements in line with the principle of beneficence: do not harm, and maximize possible benefits for research while minimizing any potential harm on others. The idea that
medical professional A health professional, healthcare professional (HCP), or healthcare worker (sometimes abbreviated as HCW) is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a Nursing, nur ...
s and researchers would always practice beneficence seems natural to most patients and research participants, but in fact, every health intervention or research intervention has potential to harm the recipient. There are many different precedents in medicine and research for conducting a
cost–benefit analysis Cost–benefit analysis (CBA), sometimes also called benefit–cost analysis, is a systematic approach to estimating the strengths and weaknesses of alternatives. It is used to determine options which provide the best approach to achieving benefits ...
and judging whether a certain action would be a sufficient practice of beneficence, and the extent to which treatments are acceptable or unacceptable is under debate. Despite differences in opinion, there are many concepts on which there is wide agreement. One is that there should be community consensus when determining
best practices A best practice is a method or technique that has been generally accepted as superior to alternatives because it tends to produce superior results. Best practices are used to achieve quality as an alternative to mandatory standards. Best practice ...
for dealing with ethical problems.


Elements

These four concepts often arise in discussions about beneficence: #one should not practice evil or do harm, often stated in
Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
as ''
Primum non nocere ' () is a Latin phrase that means "first, do no harm". The phrase is sometimes recorded as '. Non-maleficence, which is derived from the maxim, is one of the principal precepts of bioethics that all students in healthcare are taught in school ...
'' #one should prevent evil or harm #one should remove evil or harm #one should practice good Ordinary moral discourse and most philosophical systems state that a prohibition on doing harm to others as in #1 is more compelling than any duty to benefit others as in #2–4. This makes the concept of "first do no harm" different from the other aspects of beneficence. One example illustrating this concept is the
trolley problem The trolley problem is a series of thought experiments in ethics, psychology, and artificial intelligence involving stylized ethical dilemmas of whether to sacrifice one person to save a larger number. The series usually begins with a Scenario ...
. Morality and ethical theory allows for judging relative costs, so in the case when a harm to be inflicted in violating #1 is negligible and the harm prevented or benefit gained in #2–4 is substantial, then it may be acceptable to cause one harm to gain another benefit. Academic literature discusses different variations of such scenarios. There is no objective evidence which dictates the best course of action when health professionals and researchers disagree about the best course of action for participants except that most people agree that the discussions about ethics should happen.


Problem

Some outstanding problems in discussing beneficence occur repeatedly. Researchers often describe these problems in the following categories:


To what extent should the benefactor suffer harm for the beneficiary?

Many people share the view that when it is trivial to do so, people should help each other. The situation becomes more complicated when one person can help another by making various degrees of personal sacrifice. Young and Wagner provided a formula to guide decision-making for this situation. They also argued that, for healthcare professionals and other types of professionals subject to moral codes, in general beneficence takes priority over non-maleficence (“first, do good,” not “first, do no harm”) both historically and philosophically.


To whom are duties of beneficence owed?

Researchers should apply the concept of beneficence to individuals within the patient/physician relationship or the research-participant/researcher relationship. However, there is debate about the extent to which the interests of other parties, such as future patients and endangered persons, ought to be considered. When a researcher risks harm to a willing volunteer to do research with the intent to develop knowledge which will better humanity, this may be a practice of beneficence.


See also

* Values in Medical Ethics * Leaving the world a better place *
Primum non nocere ' () is a Latin phrase that means "first, do no harm". The phrase is sometimes recorded as '. Non-maleficence, which is derived from the maxim, is one of the principal precepts of bioethics that all students in healthcare are taught in school ...


References


External links

*Beauchamp, T.
The Principle of Beneficence in Applied Ethics
''
Stanford Encyclopedia of Philosophy The ''Stanford Encyclopedia of Philosophy'' (''SEP'') is a freely available online philosophy resource published and maintained by Stanford University, encompassing both an online encyclopedia of philosophy and peer-reviewed original publication ...
'', spring 2019 edition {{Research participant rights Medical ethics Concepts in ethics