Beneficence and Fiduciary Relationships

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May 8, 2012
Beneficence in Medical Ethics
The principle of beneficence is found in the Hippocratic Oath, which provides that “physicians will apply dietetic measures for the benefit of the sick according to (their) ability and judgment; and to keep the sick from harm and injustice.” (Jonathan F. Will, 2011) Our textbook claims that the Hippocratic Oath expresses an obligation of nonmaleficence and an obligation of beneficence: “I will use treatment to help the sick according to my ability and judgment, but I will never use it to injure or wrong them.” (Beauchamp & Childress, 2009) Beneficence is broken down into two parts: “positive beneficence” which is an obligation to contribute to the welfare of others and “utility” which is an obligation to produce the greatest overall benefit to the greatest number of people. Beneficence is partial; therefore, general beneficence is ideal, impartial, and specific beneficence, which is obligatory and impartial. The text claims that beneficence is the heart of healthcare. Paternalism, a form of beneficence which is in conflict with autonomy, is defined as the intentional overriding of one person’s preferences or actions by another person, where the person who overrides justifies this action by appeal to the goal of benefiting or of preventing or mitigating harm to the person whose preferences or actions are overridden. It does not prejudge whether the beneficent act is justified, obligatory, or misplaced. It further divides paternalism into soft or hard paternalism. Distinguishing between them results in a discussion of autonomy and whether it can be justified in relation to this or not. The use of several cost benefit tools and evaluations are “considered somewhat morally required to enhance our ability to make reasoned assessments of health related policies and to maximize beneficent outcomes.” (Beauchamp & Childress, 2009, p. 221) Moral problems surround the use of these tools. The...
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