Psychiatry: ethics and the law
Ben Green in Problem-based Psychiatry, 2018
There are four main ethical principles underpinning good medical care:➣ autonomy➣ beneficence➣ non-maleficence➣ justice.Autonomy literally means self-rule and would involve the patients’ right to be informed about their health and to be able to use that information to make their own decisions about whether or not to accept any particular treatment. Beneficence is a principle which hopefully lies behind the doctors’ motives for helping the individual, i.e. a desire to do the best they can to help the patient. Behind it lies the idea that one ought to prevent or remove harm or evil and do or promote good. Non-maleficence would be a principle guiding the health professional to do no harm by his or her actions, i.e. not to cause damage to the patient by intervening or by failing to intervene. Justice involves a sense of fair play regarding, say, the appropriate and fair distribution of resources or ensuring that third parties come to no harm. Health professionals use these principles to weigh up their actions or proposed actions to determine whether these are ethical or not. The ethical standards of a group, society or country are known as its ethos. Clearly, the ethos of any particular group changes with the individuals in that group, the prevailing social beliefs and many other factors – including the passage of time.
Legal and Ethical Problems in Clinical Research*
Gary M. Matoren in The Clinical Research Process in the Pharmaceutical Industry, 2020
Beneficence, according to the Commission, is often understood to cover acts of kindness or charity that go beyond strict obligation. From the viewpoint of research ethics, however, beneficence is understood in a stronger sense as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do no harm; and (2) maximize possible benefits and minimize harms. The principle of beneficence is strongly rooted in the ethical tradition of medicine. Hippocrates' epigram, "As to diseases, make a habit of two things—to help, or at least to do no harm" is, unfortunately, often oversimplified as "Do no harm (Primum non nocere)."The principle of beneficence was interpreted by the Commission as creating an obligation to secure the well-being of individuals and to develop information that will form the basis of our being better able to do so in the future. However, in the interest of securing societal benefits, we should not intentionally injure any person.
Why ethics?
David Jeffrey in Patient-centred Ethics and Communication at the End of Life, 2018
‘Do no harm’ is a Hippocratic maxim that is instilled into every medical student. However, in order to act for the good of a patient (the duty of beneficence) doctors often cause great harm. For example, in their urge to cure a patient with breast cancer doctors may employ mutilating surgery (mastectomy), or even cause death (by neutropenic sepsis). The principles of beneficence and non-maleficence are often opposed, and a balance should be sought between the prospects of a good outcome and the risk of harm, in order to produce a net benefit for the patient. Healthcare professionals need to be able to communicate the risks and probabilities of benefit in such a way that the patient understands them and is able to make an informed choice. In this way professionals both respect and enhance the patient’s autonomy with regard to making their own decision.
Beneficence, Interests, and Wellbeing in Medicine: What It Means to Provide Benefit to Patients
Published in The American Journal of Bioethics, 2020
Beneficence is a foundational ethical principle in medicine. To provide benefit to a patient is to promote and protect the patient’s wellbeing, to promote the patient’s interests. But there are different conceptions of wellbeing, emphasizing different values. These conceptions of wellbeing are contrary to one another and give rise to dissimilar ideas of what it means to benefit a patient. This makes the concept of beneficence ambiguous: is a benefit related to the patient’s goals and wishes, or is it a matter of objective criteria that constitute wellbeing? This paper suggests a unified conception of wellbeing for use in medicine to determine what counts as a benefit. Two components of wellbeing are identified: (1) objective functioning/health and (2) the patient’s view of her own good. The paper explores how to apply, balance, and weigh these components in clinical situations to determine what counts as a benefit to a patient.
Mandating Health Behaviors – How Far Should It Go?
Published in American Journal of Health Education, 2019
Using Smoke-Free and Tobacco-Free policies on college and university campuses as an example this article discusses these initiatives in the context of the role of health educators and health education programs. Issues raised are ones that health educators need to consider in any intervention effort. While the importance of intervention is well recognized, what interventions to implement are less clear and raises important philosophical, ethical and practical questions relating to issues such as individual freedom, personal autonomy, beneficence, paternalism and collective good. This article attempts to identify and discuss these issues within the context of ethical principles and the Responsibilities and Competencies for Health Education Specialists and the Health Educator Code of Ethics. It also extends the discussion to another area of concern – obesity.
Ethics in College Sexual Assault Research
Published in Ethics & Behavior, 2018
The persistently high rates of sexual assault on college campuses have led to an increasing demand for a solution to the problem. In response, research in the field is growing rapidly. With any expanding field, proper focus needs to be given to ethical dilemmas that may arise when studying a sensitive topic. College students who have experienced a sexual assault are a highly vulnerable population. As the current literature is limited, this article considers the ethical implications of conducting research with college sexual assault victims. Drawing upon the 2010 American Psychological Association Ethics Code, specific ethical concerns including respect for persons, competence, confidentiality and privacy, and beneficence and nonmaleficence are discussed. Recommendations for researchers studying sexual assault in college students are provided.