Principles of Beneficence and Non-Maleficence

In order to have a common basis of understanding some words need to be defined:

BENEFICENCE: The action of helping others and performing actions that would result in benefit to another person._

NON-MALEFICENCE:The avoidance of causing harm or evil by doing a certain action or by not doing any action at all.

PHYSICIAN: is a professional who practices medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments_.

TORT : A civil wrong committed against a person or property, excluding breach of contract.

BENEFICENCE AND NON-MALEFICENCE

As the principles of beneficence and non-maleficence are closely related, they are discussed together in this section. Beneficence involves balancing the benefits of treatment against the risks and costs involved, whereas non-maleficence means avoiding the causation of harm. As many treatments involve some degree of harm, the principle of non-maleficence would imply that the harm should not be disproportionate to the benefit of the treatment.

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Respecting the principles of beneficence and non-maleficence may in certain circumstances mean failing to respect a person's autonomy i.e. respecting their views about a particular treatment. For example, it may be necessary to provide treatment that is not desired in order to prevent the development of a future, more serious health problem. The treatment might be unpleasant, uncomfortable or even painful but this might involve less harm to the patient than would occur, were they not to have it.

In cases where the patient lacks legal competence to make a decision, medical staffs are expected to act in the best interests of the patient.

In doing so, they may take into account the principles of beneficence and non-maleficence. However, it would be helpful for medical staff in such cases, if the patient lacking capacity had made an advance directive. Nevertheless, as will be seen in the following section on "the position of advance directives alongside current wishes", problems may arise when there is a conflict between what a person requested in an advance directive and what in the physician's view is in their best interests, particularly in cases where it is no longer clear that the person in question would still agree with the decision previously made.

Examples of Beneficence:

Resuscitating a drowning victim.

Providing vaccinations for the general population.

Encouraging a person to quit smoking, etc.

Examples of Non-maleficence:

Stopping a medication that is shown to be harmful.

Refusing to provide a treatment that has not been shown to be effective.

One of the most common ethical dilemmas arises in the balancing of beneficence and non-maleficence. This balance is the one between the benefits and risks of treatment and plays a role in nearly every medical decision such as whether to order a particular test, medication, procedure, operation or treatment. By providing informed consent, physicians give patients the information necessary to understand the scope and nature of the potential risks and benefits in order to make a decision. Ultimately it is the patient who assigns weight to the risks and benefits. Nonetheless, the potential benefits of any intervention must outweigh the risks in order for the action to be ethical.

TORTS

Also known as Negligence, the person guilty of committing a tort is called TORTFEASOR.

The two types of torts are:

Intentional: such as ASSAULT (threat or bodily harm to another), BATTERY (An action that causes bodily harm or injury), DEFAMATION OF CHARACTER (An action damaging a person's reputation by making public statements), FALSE IMPRISONMENT (Intentional and unlawful restraint or confinement of one person by another), FRAUD (Intentional misrepresentation to take advantage of the resources of another person), INVASION OF PRIVACY (An intrusion into a person's seclusion or private affairs).

Unintentional: this one is when there is a non intended harm is caused but committed unreasonably or with a disregard for the consequences.

There are four elements that make a person eligible for liability. Those elements are known as ''THE FOUR D'S OF NEGLIGENCE'', which are: Duty, Derelict, Direct Cause and Damages. A complaint has to include all four elements or the court will not consider the claim.

In conclusion, the presence of these two principles is important because, they provide a system of checks and balances for providers and patients in making decisions concerning medical care, and they are necessary to a patient's autonomy or independence in making his/her own decision.