My objective of this paper is to suggest and workout a more credible form of the Principle of Beneficence from the common essential elements of the three major ethical theories (Deontology, Utilitarianism and Virtue Ethics) that will try to overcome the over-demanding objection of Utilitarianism and the rigorism of Kant’s Deontology. After analyzing these three moral systems, I find that beneficence lies within the very essence of humanity. Human beings are superior to other creatures in the world (...) due to rationality and humanity. From the humanitarian ground, a common goodness lies within every human. Beneficence, as a moral principle, is derived from this inner humanity of every individual. Despite their initial differences, utilitarianism, deontology and virtue ethics recognize this fundamental humanitarian disposition of doing good for all as a part of being a morally better person. The principle of beneficence as I suggest, is different from its consequential utilitarian notion suggested by Mill. This version of beneficence is more credible as it does not impose excessive demands upon an individual to develop any maximum beneficial outcome following utilitarian calculation of beneficence over cost, and it also strives to overcome the rigorous duty-based theory of Kantian deontology by appealing to the fundamental virtue of humanity. Finally, the credibility of this form of beneficence comes from the underlying transcendental humanism which is the chief feature of Indian tradition. (shrink)

The target article by Laacke et al. focuses on the specific context of identifying people in social media with a high risk of depression by using artificial intelligence technologies. I...

In the last ten years, there have been a number of attempts to refute Julian Savulescu's Principle of Procreative Beneficence; a principle which claims that parents have a moral obligation to have the best child that they can possibly have. So far, no arguments against this principle have succeeded at refuting it. This paper tries to explain the shortcomings of some of the more notable arguments against this principle. I attempt to break down the argument (...) for the principle and in doing so, I explain what is needed to properly refute it. This helps me show how and why the arguments of Rebecca Bennett, Sarah Stoller and others fail to refute the principle. Afterwards, I offer a new challenge to the principle. I attack what I understand to be a fundamental premise of the argument, a premise which has been overlooked in the literature written about this principle. I argue that there is no reason to suppose, as Savulescu does, that morality requires us to do what we have most reason to do. If we reject this premise, as I believe we have reason to do, the argument for Procreative Beneficence fails. (shrink)

Resumen Tomando como punto de partida las condiciones del contexto socio político donde se originó el brote epidémico del virus SARS-CoV-2, los autores analizan la influencia que tuvo el principio de beneficencia como una de las razones éticas que condujeron al oftalmólogo Li Wenliang a alertar a través de la red social Weibo, sobre el surgimiento de un brote epidémico distinto, por su agresividad, al del SARS. Se asume que dicho principio puede comprenderse a partir de un enfoque donde se (...) conjugan referentes occidentales -la primera formulación del imperativo categórico kantiano y el legado hipocrático- y orientales -el principio del Ren o humanidad, derivado del pensamiento confuciano-. El artículo concluye señalando que en un mundo interrelacionado donde las prácticas médicas tienen fundamentos científicos universales, es posible tomar decisiones éticas médicas válidas para diferentes contextos culturales, siempre y cuando se continúe avanzando en el terreno de un diálogo inter-civilizatorio con perspectiva horizontal.This article analyzes the influence of the principle of beneficence as one of the ethical reasons that led ophthalmologist Li Wenliang to alert, using the Weibo plaform, about the emergence of an epidemic outbreak different from SARS. Accordingly, we discuss the socio-political context of the SARS-CoV-2 epidemic in China. We assume that the principle of beneficence might be understood from an approach combining Western references - the first formulation of the Kantian categorical imperative and the Hippocratic legacy - with Oriental ones - the Ren or humanity, derived from Confucian thought. We conclude that in an interrelated world, with medical practices having universal scientific foundations, it is possible to validate medical ethical decisions from different cultural contexts, as long as progress continues in the field of an inter-civilizational dialogue with a horizontal perspective. (shrink)

Although written primarily for medical research, the Belmont principles have permeated clinical medicine as well. In fact, they are part of a broad cultural shift that has dramatically reworked the relationship between doctor and patient. In the early 1950s, medicine was about making the patient better and maintaining optimism when the patient could not get better. By the 1990s, medicine was about the treatment of specific physiological systems, as directed by the patient, but as limited by the society's concern for (...) justice. (shrink)

Molecular genetic engineering technologies such as CRISPR/Cas9 have made the accurate and safe genetic engineering of human embryos possible. Further advances in genomics have isolated genes that predict qualities and traits associated with intelligence. Given these advances, prospective parents could use these biotechnologies to genetically engineer future children for genes that enhance their intelligence. While Julian Savulescu’s Principle of Procreative Beneficence (PPB) argues for the moral obligation of prospective parents to use in-vitro fertilization and preimplantation genetic diagnosis to (...) make eugenic selections of embryos for intelligence, the PPB could imply obligations to genetically engineer selected embryos for intelligence as well. I argue that the PPB implies an additional moral obligation for prospective parents to genetically engineer the embryonic germline identity of selected embryos for genes that predict intelligence. Objections to my argument for the PPB’s extension are also discussed. (shrink)

The claim that we have a moral obligation, where a choice can be made, to bring to birth the 'best' child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, (...) however, has been unable, thus far, to discredit this Principle convincingly and as a result its influence shows no sign of abating. I will argue that while criticisms of the implications and detail of the reasoning behind it are well founded, they are unlikely to produce an argument that will ultimately discredit the obligation that the Principle of Procreative Beneficence represents. I believe that what is needed finally and convincingly to reveal the fallacy of this Principle is a critique of its ultimate theoretical foundation, the notion of impersonal harm. In this paper I argue that while the notion of impersonal harm is intuitively very appealing, its plausibility is based entirely on this intuitive appeal and not on sound moral reasoning. I show that there is another plausible explanation for our intuitive response and I believe that this, in conjunction with the other theoretical criticisms that I and others have levelled at this Principle, shows that the Principle of Procreative Beneficence should be rejected. (shrink)

The Principle of Procreative Beneficence claims that we have a moral obligation, where choice is possible, to choose to create the best child we can. The existence of this moral obligation has been proposed by John Harris and Julian Savulescu and has proved controversial on many levels, not least that it is eugenics, asking us to produce the best children we can, not for the sake of that child's welfare, but in order to make a better society. These (...) are strong claims that require robust justification that can be open to scrutiny and debate. This article argues that robust justifications are currently lacking in the work of Savulescu and Harris. The justifications provided for their conclusions about this obligation to have the best child possible rely heavily on Derek Parfit's Non-Identity Problem and the intuitive response this provokes in many of us. Unfortunately Harris and Savulescu do not embrace the entirety of the Non-Identity Problem and the puzzle that it presents. The Non-Identity Problem actually provides a refutation of PPB. In order to establish PPB as a credible and defendable principle, Harris and Savulescu need to find what has eluded Parfit and many others: a solution to the Non-Identity Problem and thus an overturning of the refutation it provides for PPB. While Harris and Savulescu do hint at possible but highly problematic solutions to the Non-Identity Problem, these are not developed or defended. As a result their controversial is left supported by little more than intuition. (shrink)

The principle of procreative beneficence, first suggested by Julian Savulescu, argues that: If couples have decided to have a child, and selection is possible, then they have a significant moral reason to select the child, of the possible children they could have, whose life is expected, in light of the relevant available information, to go best or at least not worse than any of the others. While the validity of this moral principle has been widely contested, in (...) this paper we move away from these issues and grant, for the sake of argument, that PB is a valid moral principle, and that the justification for PB provided by Savulescu and co-authors is sound. We do this in order to explore the implications and consequences of accepting PB and show that even if we put aside questions about the validity and theoretical foundations of this principle, PB has many interesting, astonishing and highly problematic implications that have not been made explicit in the writing of Savulescu and others who support the notion of an obligation to bring to birth the best child possible :204, 2002). We suggest that these implications should be taken into account when considering both the soundness and strength of PB. (shrink)

Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) cause such (...) harm. My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior. (shrink)

Discussions of reproductive responsibility generally draw heavily upon the principles of nonmaleficence and beneficence. However, these principles are typically only applied to women due to the incorrect belief that only women can cause fetal harm. The cultural perception that women are likely to cause fetal and child harm is reflected in numerous social norms, policies, and laws. Conversely, there is little public discussion of men and fetal and child harm, which implies that men do not (or cannot) cause such (...) harm. My goal in this paper is to begin to fill the void in the academic literature about men’s reproductive responsibility by highlighting the health-related, economic, and social harms men can cause to potential fetuses and children and then examining what it would mean to hold them responsible for preventing these harms. Applying the principles of nonmaleficence and beneficence to men, I conclude that men have a moral duty to use contraception if their behavior—past, current, or future—could harm the potential fetuses and children who result from their unprotected sexual behavior. (shrink)

This chapter aims to show that prospective parents are not bound in their reproductive decision making by a principle of procreative beneficence. That is, they have no obligation (as Julian Savulescu, the principle’s originator, famously thinks they have) to choose the possible child, from a range of possible children they might have, who is likely to lead the best life. I will summarise and clarify the content of previous papers of mine, in which I argue that since (...) the sorts of considerations that underlie the principle of procreative beneficence do not constitute reasons when viewed from a perspective that it is fitting and appropriate for a prospective parent to take up, there can be no requirement for prospective parents to be moved by those considerations. (shrink)

Principles of bcnciiccnce require us to promote the good. If we believe that a plausible mom] conception will contain some such principle, we must address the issue of the demands it imposes on agents. Some writers have defended extremely demanding principles, while others have argued that only principles with limited demands are acceptable. In this paper I su ggest that we 100k at the demands 0f beneficencc in a different way; 0ur concern should not just be with the extent (...) of the demands faced by individual agents. Instead, we should consider how the demands imposed Ol'] an agent by a principle of beneiiccncc are affected by the level of compliance with the principle by others. Act—[email protected], for example, in effect requires each complying agent to shoulder her share of the demands of bcncficcnce plus as many of the shares of noncomplying agents as would be optimal. I suggest that we focus OH this feature ofconsequentialism, and not just on the very high demands it can impose Ol'] individual agents. Thus I defend the View that principles of beneiicence should not demand more of agents as expected compliance by othcr agents decreases, and formulate a principle of bencficcnce that meets this condition. This View about beneiicence and compliance is supported by a particular conception 0f beneiiccnce. Rather than as an aim we each have as individuals, benciicence could be understood as a cooperative project, where each of us aims to promote the good together with others. If s0, it would be natural t.. (shrink)

The Principles of Biomedical Ethics by Beauchamp and Childress is a classic in the field of medical ethics. The first edition was published in 1979 and “unleashed” the four principles of respect for autonomy, non-maleficence, beneficence, and justice on the newly emerging field. These principles were argued to be mid-level principles mediating between high-level moral theory and low-level common morality, and they immediately became very popular in writings about medical ethics. Over the years Beauchamp and Childress have developed this (...) approach and vigorously defended it against the various criticisms that have been raised. The 5th edition of this book is, as all the …. (shrink)

Rebecca Bennett, in a recent paper dismissing Julian Savulescu's principle of procreative beneficence, advances both a negative and a positive thesis. The negative thesis holds that the principle's theoretical foundation – the notion of impersonal harm or non-person-affecting wrong – is indefensible. Therefore, there can be no obligations of the sort that the principle asserts. The positive thesis, on the other hand, attempts to plug an explanatory gap that arises once the principle has been rejected. (...) That is, it holds that the intuitions of those who adhere to the principle are not genuine moral intuitions, but instead simply give voice to mere (non-moral) preferences. This paper, while agreeing that Savulescu's principle does not express a genuine moral obligation, takes issue with both of Bennett's theses. It is suggested that the argument for the negative thesis is either weak or question-begging, while there is insufficient reason to suppose the positive thesis true. (shrink)

Rebecca Bennett, in a recent paper dismissing Julian Savulescu's principle of procreative beneficence, advances both a negative and a positive thesis. The negative thesis holds that the principle's theoretical foundation – the notion of impersonal harm or non‐person‐affecting wrong – is indefensible. Therefore, there can be no obligations of the sort that the principle asserts. The positive thesis, on the other hand, attempts to plug an explanatory gap that arises once the principle has been rejected. (...) That is, it holds that the intuitions of those who adhere to the principle are not genuine moral intuitions, but instead simply give voice to mere (non‐moral) preferences.This paper, while agreeing that Savulescu's principle does not express a genuine moral obligation, takes issue with both of Bennett's theses. It is suggested that the argument for the negative thesis is either weak or question‐begging, while there is insufficient reason to suppose the positive thesis true. (shrink)

Analyzes the moral problems confronting health care practitioners from a wide variety of perspectives, especially those connected by four major ethical principles--respect for autonomy, beneficence, non-maleficence and justice.

In this companion volume to their 1981 work, A Philosophical Basis of Medical Practice, Pellegrino and Thomasma examine the principle of beneficence and its role in the practice of medicine. Their analysis, which is grounded in a thorough-going philosophy of medicine, addresses a wide array of practical and ethical concerns that are a part of health care decision-making today. Among these issues are the withdrawing and withholding of nutrition and hydration, competency assessment, the requirements for valid surrogate decision-making, (...) quality-of-life determinations, the allocation of scarce health care resources, medical gatekeeping, and for-profit medicine. The authors argue for the restoration of beneficence to its place as the fundamental principle of medical ethics. They maintain that to be guided by beneficence a physician must perform a right and good healing action which is consonant with the individual patient 's values. In order to act in the patient 's best interests, or the patient 's good, the physician and patient must discern what that good is. This knowledge is gained only through a process of dialogue between patient and/or family and physician which respects and honors the patient 's autonomous self-understanding and choice in the matter of treatment options. This emphasis on a dialogical discernment of the patient 's good rejects the assumption long held in medicine that what is considered to be the medical good is necessarily the good for this patient. In viewing autonomy as a necessary condition of beneficence, the authors move beyond a trend in the medical ethics literature which identifies beneficence with paternalism. In their analysis of beneficence, the authors reject the current emphasis on rights- and duty-based ethical systems in favor of a virtue-based theory which is grounded in the physician- patient relationship. This book's provocative contributions to medical ethics will be of great interest not only to physicians and other health professionals, but also to ethicists, students, patients, families, and all others concerned with the relationship of professional to patient and patient to professional in health care today. (shrink)

The Principles of Biomedical Ethics by Beauchamp and Childress is a classic in the field of medical ethics. The first edition was published in 1979 and “unleashed” the four principles of respect for autonomy, non-maleficence, beneficence, and justice on the newly emerging field. These principles were argued to be mid-level principles mediating between high-level moral theory and low-level common morality, and they immediately became very popular in writings about medical ethics. Over the years Beauchamp and Childress have developed this (...) approach and vigorously defended it against the various criticisms that have been raised. The 5th edition of this book is, as all the …. (shrink)

The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling (...) is reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions. (shrink)

If you came upon a small child drowning in a pond, you ought to save the child even at considerable cost and risk to yourself. In 1972 Peter Singer observed that inhabitants of affluent industrialized societies stand in exactly the same relationship to the millions of poor inhabitants of poor undeveloped societies that you would stand to the small child drowning in the example just given. Given that you ought to help the drowning child, by parity of reasoning we ought (...) to help the impoverished needy persons around the globe. To capture this intuition Singer proposed this principle of benevolence: If one can prevent some significant bad from occurring, without sacrificing anything of comparable moral importance, one ought morally to do so.1 Premature death caused by preventable disease, injury, and poverty is uncontroversially a significant bad. Donations to charitable organizations such as Oxfam can prevent many of these deaths around the world, so Singer’s principle holds that we ought to donate (or take some action that is comparably efficient at saving lives). (shrink)

The Principles of Biomedical Ethics by Tom L Beauchamp and James F Childress which is now in its fourth edition has had a great influence on the development of bioethics through its exposition of a theory based on the four principles: respect for autonomy; non-maleficence; beneficence, and justice (1). The theory is developed as a common-morality theory, and the present paper attempts to show how this approach, starting from American common-morality, leads to an underdevelopment of beneficence and justice, (...) and that the methods offered for specification and balancing of principles are inadequate. (shrink)

The Groundwork is explicitly concerned with the formulation of the supreme principle of morality. Although happiness is, for Kant, a necessary aim of human action, it is not a duty to seek one's own happiness, since every man seeks his own happiness by nature in any case, and so does not have to be constrained to do so. The positive aspect of beneficence is mentioned by Kant in the derivation from the formula of humanity, where he remarks that (...) to take another person as an end in himself is to take his ends as one's own. There is one important strand in Kant's notion of treating humanity as an end‐in‐itself, and he brings this out in listing perfect duties to oneself and duties of respect to others. The initial implausibility of Kant's ethics is the thought that one can will something in the absence of any desire whatsoever. (shrink)

In this paper, we address the question of whether AI should be used for suicide prevention on social media data. We focus on algorithms that can identify persons with suicidal ideation based on their postings on social media platforms and investigate whether private companies like Facebook are justified in using these. To find out if that is the case, we start with providing two examples for AI-based means of suicide prevention in social media. Subsequently, we frame suicide prevention as an (...) issue of beneficence, develop two fictional cases to explore the scope of the principle of beneficence and apply the lessons learned to Facebook’s employment of AI for suicide prevention. We show that Facebook is neither acting under an obligation of beneficence nor acting meritoriously. This insight leads us to the general question of who is entitled to help. We conclude that private companies like Facebook can play an important role in suicide prevention, if they comply with specific rules which we derive from beneficence and autonomy as core principles of biomedical ethics. At the same time, public bodies have an obligation to create appropriate framework conditions for AI-based tools of suicide prevention. As an outlook we depict how cooperation between public and private institutions can make an important contribution to combating suicide and, in this way, put the principle of beneficence into practice. (shrink)

The two best known objections to Kant's first defense of the duty of beneficence are examined and found to be fallacious. The first objection relies on the possibility of imagining an individual who would be willing for the maxim of nonbeneficence to be a universal law (but it fails to recognize that such an individual is not a rational person and thus not subject to morality at all); and the second objection, while granting the nonuniversalizability of the maxim of (...) nonbeneficence, puts forth the maxim of “occasional” benefit in place of the maxim of beneficence as an alternative to the maxim of nonbeneficence (but it fails to recognize that the maxim of “occasional” benefit is disqualified by Kant's first moral principle). (shrink)

The principles of biomedical ethics – autonomy, non-maleficence, beneficence, and justice – are of paradigmatic importance for framing ethical problems in medicine and for teaching ethics to medical students and professionals. In order to underline this significance, Tom L. Beauchamp and James F. Childress base the principles in the common morality, i.e. they claim that the principles represent basic moral values shared by all persons committed to morality and are thus grounded in human moral psychology. We empirically investigated the (...) relationship of the principles to other moral and non-moral values that provide orientations in medicine. By way of comparison, we performed a similar analysis for the business & finance domain. (shrink)

The discussion of migrants’ education focuses generally on whether and how host countries should educate their migrant populations, examining the goals and moral principles underlying educational services for immigrants. While apparently innocuous, such formulations of the issue stipulate a framework with clear roles: host countries are posited as providers and immigrants as recipients of services. Host countries are, thus, placed in a hierarchical position of ‘granting’ belonging, ‘granting’ services, ‘granting’ education, as benefactors, whether for the purposes of duty, utility, or (...) justice. In this paper, I challenge this unidirectional order of beneficence. I propose that the inclusion of migrants in public institutions should more properly be viewed (also) as providing a necessary good/service for the host communities. The encounter with the alien, the foreign, the migrant, in oneself and in one’s world, forces individuals and communities to reflect on what and who they are as well as what and who they want to be – their identity and their future development. I argue that migrant populations with diverse linguistic traditions and customs are uniquely situated to bring to consciousness and help denaturalize the given traditions and culture of their host communities and thus make possible a more self-aware, informed, and freer path of development for their host countries. (shrink)

This paper is an examination of the ethical principles of effective altruism as they are articulated by Peter Singer in his book The Most Good You Can Do. It discusses the nature and the plausibility of the principles that he thinks both guide and ought to guide effective altruists. It argues in § II pace Singer that it is unclear that in charitable giving one ought always to aim to produce the most surplus benefit possible and in § III that (...) there is a more attractive set of principles than the ones Singer outlines that ought to guide effective altruists in their philanthropic practices and in their lives more generally. These principles fit better with his practical ambitions and with plausible attitudes about the limits of beneficence. (shrink)

This book critically analyses the basic questions regarding the principle of beneficence within its moral domain, to suggest and work out a more credible form of Principle of Beneficence. The Moral Quest for a More Credible Principle of Beneficence evolves from the common goodness of the three major confronting theories of ethics, i.e., Utilitarianism, Deontology, and Virtue Ethics. After analysing and exploring the common ground of the three views, the aim is to prescribe a (...) more convincing form of the principle of beneficence. -/- The book starts with a brief discussion of the principle of beneficence and then critically analyses previous views related to the principle of beneficence, virtue of benevolence, and their relationship, and proposes a more credible form of the Principle of Beneficence. The Moral Quest for a More Credible Principle of Beneficence aims to provide a significant contribution towards the theory of beneficence. (shrink)

Inadequate pain control, especially in older adults, remains a significant issue when caring for this population. Older adults, many of whom experience multiple acute and chronic conditions, are especially vulnerable to having their pain seriously underassessed and inadequately treated. Nurses have an ethical obligation to appropriately treat patients’ pain. To fulfill their ethical obligation to relieve pain in older patients, nurses often need to advocate on their behalf. This article provides an overview of the persistent problem of undertreated pain in (...) older adults and explores how nurses can meet this ethical duty through the application of Beauchamp and Childress’ three principles of beneficence. (shrink)

One of the goals of medicine is to improve well-being, in line with the principle of beneficence. Likewise, scientists claim that the goal of human embryonic stem cell research is to find treatments for diseases. In hESC research, stem cells are harvested from a 5-day-old embryo. Surplus embryos from infertility treatments or embryos created for the sole purpose of harvesting stem cells are used in the research, and in the process the embryos get destroyed. The use of human (...) embryos for research purpose raises ethical concern. In this context, the religious leaders play the role to be the moral compass and “reality check” to engage with the public. In Malaysia, the Ministry of Health has outlined the Guidelines for Stem Cell Research and Therapy, reflecting on Islamic principles. Since there has not been much focus on the viewpoints of other faiths in Malaysia, this study attempts to explore the ethical guiding principles deliberated by religious leaders from the Buddhist, Hindu and Catholic traditions and identify if there is a common ground between the mainstream religious views and principles of medical ethics, in relation to hESC research. Eleven religious leaders representing the Buddhist, Hindu and Catholic traditions were interviewed. Interestingly, though reasoning of religious leaders came from different angles, their underlying concerns revolve around the values of “do no harm” and “intention to save lives”. These values are also the key principles in medical ethics. The findings are applied to answer the question as to whether religious and medical guiding principles can co-exist and complement in ethical decision-making, without compromising the values. (shrink)

Beauchamp and Childress here collaborate to provide a set of action-guides or principles which in their judgment apply to a wide range of biomedical problems. Their work consists of eight chapters and two appendices. In the first two chapters attention centers on the nature of a moral dilemma and moral reasoning and on types of normative ethical theories. Chapters 3 through 6 discuss the principles of autonomy, nonmaleficence, beneficence, and justice, while chapters 7 and 8 deal, respectively, with the (...) professional-patient relationship and with the role that virtues, ideals, personal integrity, and conscience have to play in the moral life. Appendix I provides twenty-nine case studies illustrating dilemmas in biomedical ethics, and reference to those studies is made throughout the text. Appendix II gives the texts of important biomedical codes of ethics. (shrink)

Increasingly, contemporary medical ethicists have become aware of the need to explicate a foundation for their various models of applied ethics. Many of these theories are inspired by the apparent incompatibility of patient autonomy and provider beneficence. The principle of patient autonomy derives its current primacy to a large extent from its legal origins. However, this principle seems at odds with the clinical reality. In the bioethical literature, the notion of authenticity has been proposed as an alternative (...) foundational principle to autonomy. This article examines this proposal in reference to various existentialist philosophers (Heidegger, Sartre, Camus and Marcel). It is concluded that the principle of autonomy fails to do what it is commonly supposed to do: provide a criterion of distinction that can be invoked to settle moral controversies between patients and providers. The existentialist concept of authenticity is more promising in at least one crucial respect: It acknowledges that the essence of human life disappears from sight if life's temporal character is reduced to a series of present decisions and actions. This also implies that the very quest for a criterion that allows physicians to distinguish between sudden, unexpected decisions of their patients to be or not to be respected, without recourse to the patient's past or future, is erroneous. (shrink)

Background There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers Beachump and Childress formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'Four Principles' were presented by the authors as universal and applicable to any culture and society. Mawlana, a great figure in Sufi tradition, had written many books which not only guide people how to worship God to be close to Him, but also advise people how (...) to lead a good life to enrich their personality, as well as to create a harmonious society and a peaceful world. Methods In this study we examined the major works of Mawlana to find out which of these 'Four Principles of Bioethics' exist in Mawlana's ethical understanding. Results We have found in our study that all these principles exist in Mawlana's writings and philosophy in one form or another. Conclusions We have concluded that, further to Beachump and Childress' claim that these principles are universal and applicable to any culture and society, these principles have always existed in different moral traditions in different ways, of which Mawlana's teaching might be presented as a good example. (shrink)

BackgroundThis study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups.MethodThis study is based on 12 semi-structured interviews with (...) three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.ResultsIn this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice.ConclusionThis study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. (shrink)

Principlism, the bioethical theory championed by Tom Beauchamp and James Childress, is centered on the four moral principles of beneficence, non-maleficence, respect for autonomy, and justice. Two key processes related to these principles are specification—adding specific content to general principles—and balancing—determining the relative weight of conflicting principles. I argue that both of these processes necessarily involve an appeal to human goods and evils, and therefore require a theory of the good. A significant problem with principlism is that it lacks (...) a theory of the good and consequently does not have an adequate solution to the problems of specification and balancing. My conclusion is that principlism must adopt some account of human well-being in order to be a satisfactory bioethical framework. (shrink)

In this paper, I will examine how the role of hope can inform our interpretation of the classical principles of medical ethics. Defining hope as a future-oriented expectation for the good, I will look at how it can shape our understanding of justice, beneficence, respect for autonomy and non-maleficence. I will suggest that ethically engaging with these principles in medical practice requires placing value on the patient–practitioner relation as a mode of hope. Engaging the writings of Emmanuel Lévinas and (...) Søren Kierkegaard, I will show how hope reveals itself through responsible and expectant relationship, even in the midst of suffering. (shrink)

Given intractable secular moral pluralism, the force and significance of the four principles (autonomy, beneficence, non-maleficence, and justice) of Tom Beauchamp and James Childress must be critically re-considered. This essay examines the history of the articulation of these four principles of bioethics, showing why initially there was an illusion of a common morality that led many to hold that the principles could give guidance across cultures. But there is no one sense of the content or the theoretical justification of (...) these principles. In addition, a wide range of secular moral and bioethical choices has been demoralized into lifestyle choices; the force of the secular moral point of view has also been deflated, thus compounding moral pluralism. It is the political generation of the principles that provides a common morality in the sense of an established morality. The principles are best understood as embedded not in a common morality, sensu stricto, but in that morality that is established at law and public policy in a particular polity. Although moral pluralism is substantive and intractable at the level of moral content, in a particular polity a particular morality and a particular bioethics can be established, regarding which health care ethics consultants can be experts. Public morality and bioethics are at their roots a political reality. (shrink)

Beneficence is one of the four principles that form the basis of the Australian National Statement. The aim of this paper is to explore the philosophical development of this principle and to clarify the role that beneficence plays in contemporary discussions about human research ethics. By examining the way that guidance documents, particularly the National Statement, treats beneficence we offer guidance to researchers and human research ethics committee members on the practical application of what can be (...) a conceptually difficult principle. (shrink)

The chronic worldwide lack of organs for transplantation and the continuing improvement of strategies for in situ organ preservation have led to renewed interest in elective non-therapeutic ventilation of potential organ donors. Two types of situation may be eligible for elective intensive care: patients definitely evolving towards brain death and patients suitable as controlled non-heart beating organ donors after life-supporting therapies have been assessed as futile and withdrawn. Assessment of the ethical acceptability and the risks of these strategies is essential. (...) We here offer such an ethical assessment using the four principles of medical ethics of Beauchamp and Childress applying them in their broadest sense so as to include patients and their families, their caregivers, other potential recipients of intensive care, and indeed society as a whole. The main ethical problems emerging are the definition of beneficence for the potential organ donor, the dilemma between the duty to respect a dying patient's autonomy and the duty not to harm him/her, and the possible psychological and social harm for families, caregivers other potential recipients of therapeutic intensive care, and society more generally. Caution is expressed about the ethical acceptability of elective non-therapeutic ventilation, along with some proposals for precautionary measures to be taken if it is to be implemented. (shrink)

Tom Beauchamp and James Childress have always maintained that their four principles approach (otherwise known as principlism) is a globally applicable framework for biomedical ethics. This claim is grounded in their belief that the principles of respect for autonomy, non-maleficence, beneficence and justice form part of a 'common morality', or collection of very general norms to which everyone who is committed to morality subscribes. The difficulty, however, has always been how to demonstrate, at least in the absence of a (...) full-blooded analysis of the concept of morality, whether the four principles are foundational, and so globally applicable, in this way. In the recently published sixth edition of Principles of Biomedical Ethics, an imaginative and non-question-begging empirical method of determining the common morality's norms is suggested. In this paper, I outline this method, before arguing that it is difficult to see how it might be thought to achieve its purpose. (shrink)

The current environmental crisis can be approached, through many perspectives, as a civilizational crisis. Alternatives of human transcendence are identified in the Inca civilization to compensate for the malaise that characterizes the actual crisis. There is a multicultural dimension to the manifestations of Hoasca occurring in Amazonian countries. As employed by the Beneficent Spiritist Center União do Vegetal in a religious context, it can contribute to the reconstruction of buen vivir, which served as the principle of the civilizations that (...) preceded the colonization of the Americas by Europeans. Today, the State openly confronts the manifestation of the constitutional principles of buen vivir, religious freedom, and the protection of this cultural heritage. Here, the implications of the civilizational crisis and ways of overcoming it are approached from the standpoint of deep ecology, but the implications also reflect the doctrinal vision of the UDV to which the authors are affiliated. (shrink)

Following the recent condemnation of the National Health Service charging regulations by medical colleges and the UK Faculty of Public Health, we demonstrate that through enactment of this policy, the medical profession is betraying its core ethical principles. Through dissection of the policy using Beauchamp and Childress’ framework, a disrespect for autonomy becomes evident in the operationalisation of the charging regulations, just as a disregard for confidentiality was apparent in the data sharing Memorandum of Understanding. Negative consequences of the regulations (...) are documented to highlight their importance for clinical decision makers under the principles of beneficence and non-maleficence. Exploration of the principle of justice illuminates the core differentiation between the border-bound duties of the State and borderless duties of the clinician, exposing a fundamental tension. (shrink)

In Clinical Ethics, Robert Timko argues that the moral dilemmas of clinical medical practice can best be resolved within a framework of prima facie duties, and that the most stringent duty is that of nonmaleficence. Timko shows that respect for individual autonomy and the principle of beneficence are inadequate for the moral practice of medicine since simple adherence to either principle may be insufficient for the provision of "due care.".

A background assumption in much contemporary political philosophy is that justice is the first virtue of social institutions, taking priority over other values such as beneficence. This assumption is typically treated as a methodological starting point, rather than as following from any particular moral or political theory. In this paper, I challenge this assumption. To frame my discussion, I argue, first, that justice doesn’t in principle override beneficence, and second, that justice doesn’t typically outweigh beneficence, since, (...) in institutional contexts, the stakes of beneficence are often extremely high. While there are various ways one might resist this argument, none challenge the core methodological point that political philosophy should abandon its preoccupation with justice and begin to pay considerably more attention to social beneficence—that is, to beneficence understood as a virtue of social institutions. Along the way, I also highlight areas where focusing on social beneficence would lead political philosophers in new and fruitful directions, and where normative ethicists focused on personal beneficence might scale up their thinking to the institutional case. GPI Working Paper No. 11-2022. (shrink)

I argue for three principles of minimal beneficence, which constrain when and what at least we are obligated to do on behalf of someone. All three may be accepted by both the consequentialist Peter Singer and by his staunch opponents in material value-ethics, who are typically anti-consequentialists. Either side would philosophically benefit from accepting the principles. At the same time, the first principle is rarely applicable, the second only when the available relevant evidence is not too complex, and (...) the third only as a prompt to keep thinking seriously about how to practice beneficence. Even so, I derive some widely applicable, practical implications. (shrink)