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