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. (shrink)

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)

Imagine a world where everyone is healthy, intelligent, long living and happy. Intuitively this seems wonderful albeit unrealistic. However, recent scienti c breakthroughs in genetic engineering, namely CRISPR/Cas bring the question into public discourse, how the genetic enhancement of humans should be evaluated morally. In 2001, when preimplantation genetic diagnosis (PGD) and in vitro fertilisation (IVF), enabled parents to select between multiple embryos, Julian Savulescu introduced the principle of procreative bene cence (PPB), stating that parents have the obligations to choose (...) the child that is expected to have the best life. In this paper I argue that accepting the PPB and the consequentialist principle (CP) that two acts with the same consequences are morally on par, commits one to accepting the parental obligation of genetically enhancing one's children. (shrink)

This chapter examines the explicit and implicit roles that the concept of beneficence plays in the guidelines that govern biomedical research involving humans. We suggest that the role beneficence is actually playing in the guidelines is more comprehensive than is commonly assumed. The broader conceptualisation of beneficence proposed here clarifies the relationship of beneficence to respect for autonomy. It does this by showing how respect for autonomy is at the service of beneficence rather than in (...) tension with it. (shrink)

This chapter contains section titled: I II III Acknowledgement.

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy (...) has at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

Common sense tells us that in certain circumstances, helping someone is morally obligatory. That intuition appears incompatible with Kant's account of beneficence as a wide imperfect duty, and its implication that agents may exercise latitude over which beneficent actions to perform. In this paper, I offer a resolution to the problem from which it follows that some opportunities to help admit latitude and others do not. I argue that beneficence has two components: the familiar wide duty to help (...) others achieve their ends and a narrow duty to avoid indifference to others as end-setters. Although we are not always required to help, we are always required not to be indifferent. When helping someone is the only way not to be indifferent to a person, helping him/her is obligatory. My account avoids certain difficulties with other proposed solutions and can also address an important concern about proximity. (shrink)

Consider a duty of beneficence towards a particular individual, S, and call a reason that is grounded in that duty a “beneficence reason towards S.” Call a person who will be brought into existence by an act of procreation the “resultant person.” Is there ever a beneficence reason towards the resultant person for an agent to procreate? In this paper, I argue for such a reason by appealing to two main premises. First, we owe a pro tanto (...) duty of beneficence to future persons; and second, some of us can benefit some of those persons by procreating. In support of the first premise I reject the presentist account of time in favor of the view that future persons are just as real as presently existing persons. I then argue that future persons are like us in all the morally relevant ways, and since we owe duties of beneficence to each other, we also owe duties of beneficence to future persons. In support of the second premise I offer an account of benefiting according to which an individual can be benefited by an action even if it makes her no better off than she would have been, had the action not been performed. This account of benefiting solves what I call the “non-identity benefit problem.” Finally, I argue that having a life worth living is a benefit, and some of us can cause some persons that benefit by causing them to exist. (shrink)

It is plausible to think that it is wrong to cure many people’s headaches rather than save someone else’s life. On the other hand, it is plausible to think that it is not wrong to expose someone to a tiny risk of death when curing this person’s headache. I will argue that these claims are inconsistent. For if we keep taking this tiny risk then it is likely that one person dies, while many others’ headaches are cured. In light of (...) this inconsistency, there is a conflict in our intuitions about beneficence and chance. This conflict is perplexing. And I have not been able to find a satisfactory way of resolving it. Perhaps you can do better? (shrink)

The argument of Julian Savulescu’s 2001 paper, “Procreative Beneficence: Why We Should Select the Best Children” is flawed in a number of respects. Savulescu confuses reasons with obligations and equivocates between the claim that parents have some reason to want the best for their children and the more radical claim that they are morally obligated to attempt to produce the best child possible. Savulescu offers a prima facie implausible account of parental obligation, as even the best parents typically fail (...) to do everything they think would be best for their children let alone everything that is in fact best for their children. The profound philosophical difficulties which beset the attempt to formulate a plausible account of the best human life constitute a further independent reason to resile from Savulescu’s conclusion. Savulescu’s argument also requires parents to become complicit with racist and homophobic oppression, which is yet another reason to reject it. Removing the equivocation from Savulescu’s argument allows us to see that the assertion of an obligation to choose the “best child” has much more in common with the “old” eugenics than Savulescu acknowledges. (shrink)

We have a reason to use information which is available about such genes in our reproductive decision-making; (3) couples should selec.

This chapter asks what stance is morally appropriate as we consider when, whether, and how to assist persons experiencing physical, emotional, or intellectual disability. Appealing to a variety of intelligent and observant thinkers for inspiration (Ralph Barton Perry, Helen Keller, and Immanuel Kant), it argues that one important aspect of such a stance is an attitude of reciprocal beneficence. This has three central aspects: a perspective of fellowship acknowledging the disabled and the currently able as members of the community (...) of vulnerable human agents; a developed sympathy attuned to gaps in knowledge and failures of imagination and analogy; and a readiness to show gratitude or appreciation for what the currently disabled may teach about the vulnerable moral agency we share. The argument takes initial inspiration from Perry but owes most to its roots in Kantian moral and political theory. It also owes much to wise and insightful enrichments due to Keller. (shrink)

Recently, Julian Savulescu and Guy Kahane have defended the Principle of Procreative Beneficence (PB), according to which prospective parents ought to select children with the view that their future child has ‘the best chance of the best life’. I argue that the arguments Savulescu and Kahane adduce in favour of PB equally well support what I call the Principle of General Procreative Beneficence (GPB). GPB states that couples ought to select children in view of maximizing the overall expected (...) value in the world, not just the welfare of their future child. I further argue that Savulescu and Kahane's claim that PB has significantly more weight than competing moral principles, such as GPB, lacks justification. A possible argument for PB having significant weight builds on a principle of parental partiality towards one's own children. But this principle does not support PB; it supports a Principle of Sibling-Oriented Procreative Beneficence (SPB), according to which parents selecting a child should maximize the benefit of all their children. Indeed, PB itself will in some cases be self-effacing in favour of SPB. (shrink)

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does (...) not dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

This chapter contains sections titled: The Obligatory Ends Anti‐paternalism and the Duty of Beneficence Beneficence: The Finer Points The Question of Latitude Latitude and (Im)partiality Gratitude Sympathy Conclusion Bibliography.

Beneficence is usually regarded as adequate when it results in an actual benefit for a beneficiary and satisfies her self-chosen end. However, beneficence that satisfies these conditions can harm beneficiaries' free agency, particularly when they are robustly dependent on benefactors. First, the means that benefactors choose can have undesirable side-effects on resources that beneficiaries need for future free action. Second, benefactors may undermine beneficiaries' ability to freely deliberate and choose. It is therefore insufficient to satisfy someone's self-chosen ends. (...) Instead, good beneficence depends on whether the benefactor avoids undue influence over a beneficiary's deliberation and whether the choice of means is compatible with the beneficiary's conception of her good. Consequently, benefactors must have substantial respect for a beneficiary's free agency and the practical competence to choose means that take into account the beneficiary's conception of her good and the wider set of circumstances that influence her life. (shrink)

Julian Savulescu has given clear expression to a principle—that of “procreative beneficence”—which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective (...) parents, are in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering. (shrink)

Is implementing the beneficent nudge program morally permissible in worlds like ours? I argue that there is reason for serious doubt. I acknowledge that beneficent nudging is highly various, that nudges are in some circumstances morally permissible and even called for, and that nudges may exhibit respect for genuine autonomy. Nonetheless, given the risk of epistemic injustice that nudges typically pose, neither the moral permissibility of beneficent nudging in the abstract, nor its case-by-case vindication, appears sufficient to justify implementing a (...) nudge program in worlds like ours. Drawing on Miranda Fricker’s account of epistemic injustice, I argue that the cogent defense of any nudge program, relative to worlds like ours, stands in need of serious attention to its potential for fostering or sustaining epistemic injustice. A more specific point hinges on recognizing a form of epistemic injustice not enough attended to in the literature to date, which I call reflective incapacitational injustice. This includes relative disadvantages in the attaining of the capacity to engage in critical reason, such as the capacity to go in for potentially critical reasoned deliberation and discursive exchange concerning ends. Since Cass Sunstein’s First Law of behaviorally informed regulation would be taken, in worlds like ours, to justify indeterminately many nudges leading to such epistemic injustice we have general grounds for doubting the moral permissibility of this nudge program. We should hence oppose the implementation of any such program until it is shown not to violate the demands of epistemic justice. (shrink)

When it comes to the duty of beneficence, a formidable class of moderate positions holds that morally significant considerations emerge when one's actions are seen as part of a larger series. Agglomeration, according to these moderates, limits the demands of beneficence, thereby avoiding the extremely demanding view forcefully defended by Peter Singer. This idea has much appeal. What morality can demand of people is, it seems, appropriately modulated by how much they have already done or will do. Here (...) we examine a number of recent proposals that appeal to agglomeration. None of them, we argue, succeeds. (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)

ABSTRACTIn 2001, Julian Savulescu wrote an article entitled ‘Procreative Beneficence: Why We Should Select the Best Children’, in which he argued for the genetic selection of intelligence in children. That article contributes to a debate on whether genetic research on intelligence should be undertaken at all and, if so, should intelligence selection be available to potential parents. As such, the question of intelligence selection relates to wider issues concerning the genetic determination of behavioural traits, i.e. alcoholism. This article is (...) designed as an engagement in the intelligence selection debate using an analysis of Savulescu's arguments to raise a series of problematic issues in relation to the ethics of parental selection of intelligence. These problematic issues relate to wider assumptions that are made in order to put forward intelligence selection as a viable ethical option. Such assumptions are more generic in character, but still relate to Savulescu's article, concerning issues of genetic determinism, private allocation and inequality, and, finally, individual versus aggregate justice. The conclusion focuses on what the implications are for the question of agency, especially if intelligence selection is allowed. (shrink)

In chapter 3 of Wild Animal Ethics Johannsen argues for a collective obligation based on beneficence to intervene in nature in order to reduce the suffering of wild animals. In the same chapter he claims that the non-identity problem is merely a “theoretical puzzle” which doesn’t affect our reasons for intervention. In this paper I argue that the non-identity problem affects both the strength and the nature of our reasons to intervene. By intervening in nature on a large scale (...) we change which animals come into existence. In doing so, we enable harmful animals to inflict harms on other animals, and we put other animals in harm’s way. The harms that these animals will inflict and endure are foreseeable. Furthermore, since non-human animals aren’t moral agents, harmful animals cannot be morally responsible for their harmful actions. I argue therefore that by causing animals to exist, knowing that they will inflict and suffer harms, we become morally responsible for those harms. By engaging in identity-affecting actions then we take on secondary moral duties towards the animals we have thereby caused to exist, and these secondary moral duties may be extremely demanding, even more so than the initial costs of intervention. Finally, these duties are duties of justice rather than duties of beneficence, and as such are more stringent than purely beneficence-based moral reasons. Furthermore, this conclusion flows naturally from several plausible principles which Johannsen explicitly endorses. (shrink)

I argue that rather than aiming at the well-being of those whom we love, we should aim to share in their ends. The former stance runs the risk of being objectionably paternalistic and, as I explain, only the latter makes reciprocal relationships possible. I end by diagnosing our attraction to the idea that we should promote our loved-ones’ well-being.

According to Peter Singer, virtually all of us would be forced by adequate reflection on our own convictions to embrace a radical conclusion about giving. The following principle, he says, is “surely undeniable” -- at least once we reflect on secure convictions concerning rescue, as in his famous case of the drowning toddler.

What are we morally required to do for strangers? To answer this question – a question about the scope of requirements to aid strangers – we must first answer a question about justification: why are we required to aid them (when we are)? The main paper focuses largely on answering the question about justification, but does so in order to arrive at an answer to the question about scope. Three main issues are discussed. First, to what extent should requirements of (...) beneficence – requirements to benefit other people – be seen as generated by people’s rights to receiving aid? Secondly, what is the relationship between requirements of beneficence that apply to us collectively and requirements of beneficence that apply to each of us individually? According to Liam Murphy, our obligations to help distant strangers are fundamentally collective obligations, and any individual obligations we bear are consequently obligations to discharge our “fair share” of these collective obligations. I shall argue that, on the contrary, there are large-scale collective obligations of beneficence that derive from more fundamental individual obligations. My third issue concerns the moral significance of citizenship. What morally relevant difference is there between strangers who are compatriots and those who are not? (shrink)

Meaningful work is a key element of positive functioning of employees, but what makes work meaningful? Based on research on self-determination theory, basic psychological needs, and prosocial impact, we suggest that there are four psychological satisfactions that substantially influence work meaningfulness across cultures: autonomy (sense of volition), competence (sense of efficacy), relatedness (sense of caring relationships), and beneficence (sense of making a positive contribution). We test the relationships between these satisfactions and perceived meaningful work in Finland (n = 594, (...) employees of several organizations), India (n = 342, collected through Mturk), and the USA (n = 373, collected through Mturk). Regression analyses show that – except for competence in USA – all four satisfactions are significantly and independently associated with meaningful work. Moreover, structural equation modeling shows that they fully mediated the relationship between occupational position and work meaningfulness in India and in the USA. In sum, the results support the importance of these four satisfactions in explaining the psychological underpinnings of meaningful work. (shrink)

Volume 20, Issue 3, March 2020, Page 65-68.

This article explores the motives underlying corporate responses to the COVID-19 pandemic. The analysis begins with Thomas Dunfee’s Statement of Minimum Moral Obligation, which specifies, more precisely than any other contribution to the business ethics canon, the level of corporate beneficence required during a pandemic. The analysis then turns to Milton Friedman’s neoliberal understanding of human nature, critically contrasting it with the notion of stoic virtue that informs the works of Adam Smith. Friedman contends that beneficence should play (...) no role in corporate settings. Smith, by contrast, emphasizes the need for prudence, beneficence and self-command in all human endeavours. The article then uses these competing frameworks to reflect on a published survey of 145 corporate responses to COVID-19. In many of these responses, the benefit to a non-financial stakeholder is clear, while the financial consequence to the firm remains nebulous. This supports the contention that during a pandemic, beneficence provides a more complete explanation of many corporate actions than the profit motive alone. The article contests Friedman’s Chicago School profit imperative and goes beyond Dunfee’s SMMO by endorsing the more full-throated embrace of beneficence and stoic virtue found in the works of Smith. (shrink)

In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has (...) an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society’s medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice. (shrink)

Insufficient vaccination coverage is an important public health problem in many countries, since it leads to the loss of herd protection and the resurgence of previously exterminated diseases. However, policies of mandatory childhood vaccination capable of raising vaccination rates continue to be controversial. In this article I review the arguments for mandatory childhood vaccination, setting out the strongest teleological argument in favour, and then critically examining the two strongest potential objections: paternalism and the parental prerogative. I argue that the challenge (...) of paternalism fails because it confuses the identities of those subject to restricted liberty and those who autonomously dissent, and because non-vaccination imposes risks on others. I argue that the challenge of a parental prerogative fails because it cannot be intuitively or theoretically supported in a form that would make it permissible to impose risks on others. I conclude that in lieu of further and more plausible objections at least some policies of mandatory childhood vaccination are morally permissible. (shrink)

(2002). Therapeutic Beneficence and Patient Recruitment in Randomized Controlled Clinical Trials. The American Journal of Bioethics: Vol. 2, No. 2, pp. 35-36.

Euthanasia has once again become headline news in the UK, with the announcement by Dr Michael Irwin, a former medical director of the United Nations, that he has helped at least 50 people to die, including two between February and July 1997. He has been quoted as saying that his ‘conscience is clear’ and that the time has come to confront the issue of euthanasia. For the purposes of this article, the term ‘beneficent voluntary active euthanasia’ (BVAE) will be used: (...) beneficent from the prima facie principle of beneficence, to do good, and voluntary to indicate that this must be carried out at the request of a competent client. This implies adherence to another prima facie principle, that of respect for autonomy. Active implies that something is done or given with the intention of hastening death. The word euthanasia itself simply means ‘good death’. This article examines the moral positions of two nurses and one junior doctor towards the subject of BVAE and an attempt is made to represent the main conflicting moral positions. The central arguments against BVAE and counterarguments are presented. The conclusion reached is that consenting adults should not be prevented from availing themselves of BVAE if another consenting adult (a medical doctor) is available and capable of carrying out their wishes. This being the case, it is suggested that BVAE should be available as an option in hospices and in the community. The aims of this article are: to generate debate among professionals; to present a three-way discussion that might be useful as a focus for educational purposes, particularly at undergraduate level; to challenge professionals to confront the issue of euthanasia; and to plead the case of those who request assistance in exercising autonomy by gaining control over their own deaths. (shrink)

Scholars who favor shareholder primacy usually claim either that managers should not fulfill corporate duties of beneficence or that, if they are required to fulfill them, they do so by going against their obligations to shareholders. Distinguishing between structurally different types of duties of beneficence and recognizing the full force of the normative demands imposed on managers reveal that this view needs to be qualified. Although it is correct to think that managers, when acting on behalf of shareholders, (...) are not required to fulfill wide duties of charity, they are nevertheless required to fulfill a variety of narrow duties of beneficence. What is more, the obligation to fulfill these duties arises precisely because they are acting on behalf of shareholders. As such, this article 1) refines our understanding of the duties of corporate beneficence and 2) helps to identify which duties of beneficence are imposed on managers when they are acting on behalf of shareholders. (shrink)

Procreative Beneficence (PB) states that couples should have “the best child” they can, that means, they have a moral obligation to select the child, that “can be expected to enjoy the most well-be...

I begin with a note about moral goodness as a quality, disposition, or trait of a person or human being. This has at least two different senses, one wider and one narrower. Aristotle remarked that the Greek term we translate as justice sometimes meant simply virtue or goodness as applied to a person and sometimes meant only a certain virtue or kind of goodness. The same thing is true of our word “goodness.” Sometimes being a good person means having all (...) the virtues, or at least all the moral ones; then goodness equals the whole of virtue. But sometimes, being a good person has a narrower meaning, namely, being kind, generous, and so forth. Thus, my OED sometimes equates goodness with moral excellence as a whole and sometimes with a particular moral excellence, viz., kindness, beneficence, or benevolence; and the Bible, when it speaks of God as being good sometimes means that God has all the virtues and sometimes only that he is kind, mereiful, or benevolent. When Jesus says, “Why callest thou me good: None is good, save one, that is God,” he seems to be speaking of goodness in the inclusive sense, but when the writer of Exodus has God himself say that he is “merciful and gracious, long-suffering, and abundant in goodness and truth,” God is using “goodness” in the narrower sense in which it means benevolence, for he goes on to make it clear that he is also just and severe. Similarly, “good will” may mean either “morally good will” in general, as it does in Kant, or it may mean only “benevolent will,” as it usually does; in “men of good will” it is perhaps ambiguous. (shrink)

There can be situations in which, if I contribute to a pool of resources for helping a large number of people, the difference that my contribution makes to any of the people helped from the pool will be imperceptible at best, and maybe even non-existent. And this can be the case where it is also true that giving the same amount directly to one of the intended beneficiaries of the pool would have made a very large difference to her. Can (...) non-contribution to the pool be morally justified on this ground? I argue that it cannot. For, first, this line of thought leaves unaffected any reasons for holding that failing to perform the direct action of benefiting someone greatly would be wrong. But the pooling system of helping people is often better than a system separating the help which is given — better because of the perceptible difference it makes to its beneficiaries. If so, failing to contribute to the pool will be at least as wrong as failing to have helped directly would have been. The paper clarifies and defends an argument of this form, showing how it can be formulated in a way that avoids apparent counterexamples, and identifying the assumptions on which it rests. (shrink)

OBJECTIVES: To study and report the attitudes of patients and general practitioners (GPs) concerning the obligation of doctors to act for the good of their patients, and to provide a practical account of beneficence in general practice. DESIGN: Semi-structured interviews administered to GPs and patients. SETTING AND SAMPLE: Participants randomly recruited from an age and gender stratified list of GPs in a geographically defined region of South Australia. The sample comprised twenty-one general practitioners and seventeen patients recruited by participating (...) GPs. RESULTS: In practice, acting for the good of the patient not only accommodates the views of patients and GPs on expertise and knowing best, but also responds to the particular details of the clinical situation. Patients had a complex understanding of the expertise necessary for medical practice, describing a contextual domain in which they were expert, and which complemented the scientific expertise of their GPs. General practitioners identified multiple sources for their expertise, of which experience was the most significant. The role of the GP included responding to individual patients and particular clinical problems and ranged from the assumption of responsibility through to the proffering of medical advice. CONCLUSION: This study found that GPs acting for the good of their patients covered a variety of GP actions and patient preferences. Beneficence was not justified by presumed patient vulnerability or the inability of patients to understand medical problems, but furthered through a recognition of the different areas of expertise contributed by both parties to the consultation. (shrink)

This article deals with a discussion of Savulescu’s impersonal version of the Principle of Procreative Beneficence and its relationship with a person-affecting Principle of Harm in order to evaluate the cases of selection of which child to have. It aims to show some problems in Savulescu’s attempt to arrange the two principles (the conflict between beneficence and harm, the limitation of beneficence to pre-conception selection, the extension of beneficence to different quantity people choice), and to propose (...) an alternative version of Procreative Beneficence (a narrow person-affecting version), in order to avoid these problems. (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)

This paper explores the importance of hope as a determining factor for patients to participate in first-in-human trials for synthetic biology therapies. This paper focuses on different aspects of hope in the context of human health and well-being and explores the varieties of hope expressed by patients. The research findings are based on interview data collected from stable gout and diabetes patients. Three concepts of hope have emerged from the interviews: hope as certainty ; hope as reflective uncertainty ; hope (...) as self-therapy. The purpose of the paper is twofold. First, it aims to underline the significance of hope in patients’ medical decision-making, as well as the beneficence of hope for patients’ well-being, and for progress in research. Second, it shows how philosophical investigations—in particular Descartes—explore the phenomenon of hope and provide medical empirical research with profitable insights and tools. (shrink)

Book reviewed in this article: For the Patient's Good: The Restoration of Beneficence in Health Care. By Edmund D. Pellegrino and David C. Thomasma.

In this paper, I present briefly a view about intrinsic value, one connected to the concepts of ethically required attitudes of favor, disfavor, and preference. If lives can have both welfare value and intrinsic value, how are these values related? I defend the view that the welfare value of a life does not track the intrinsic value of that life. Some philosophers, however, deny that anything can have intrinsic value or absolute value. Some argue that to hold that something is (...) both bad for a person and bad simpliciter leads to an objectionable double counting. Others hold views that would, if true, diminish the practical importance of intrinsic value. Some hold that our relations with others should not be guided by what is intrinsically good or bad, but only by what is good or bad for someone. Others hold that the concepts of love, benefit, and harm are tied exclusively to welfare value or well-being. Still others suggest that the moral principles of beneficence and non-maleficence are tied exclusively to welfare and well-being. I argue that these views are mistaken. In this regard, I attempt to defend the practical importance of intrinsic value. (shrink)

According to the Principle of Procreative Beneficence, reproducers should choose the child, of those available to them, expected to have the best life. Savulescu argues reproducers are therefore morally obligated to select for nondisease traits, such as intelligence. Carter and Gordon recently challenged this implication, arguing that Savulescu fails to establish that intelligence promotes well-being. This paper develops two responses. First, I argue that higher intelligence is likely to contribute to well-being on most plausible accounts. Second, I argue that, (...) even if it does not, one can only resist the conclusion that reproducers should select on the basis of intelligence if its expected net effect is neutral. If intelligence reduces expected well-being, then reproducers should select offspring of low intelligence. More likely, the effect of increased intelligence on expected well-being varies at different levels, which makes identifying an optimum for well-being more complex than hitherto appreciated. (shrink)

Simple acts of kindness that are performed sincerely and with evident good will can also, paradoxically, be perceived as deeply insulting by the people we succeed in benefiting. When we are moved to help someone out of genuine concern for her, when we have no intention to humiliate or embarrass her and when we succeed at benefiting her, how can our generosity be disparaging or demeaning to her? Yet, when the tables are turned, we sometimes find ourselves brusquely refusing assistance (...) from others or accepting it only grudgingly while trying to show that we do not need their charity. People with disabilities often find ourselves in situations of this sort, where we bristle at others who rush to open doors for us, for instance, while our kindhearted benefactors are surprised and hurt by the cold reception they receive for their efforts. My aim is to explain some of the ways in which well-intentioned and effective beneficence can be offensive, with special emphasis on cases in which someone provides assistance to a disabled person. (shrink)

Some philosophers claim that there is no morally relevant distinction to be made between duties of rescue and beneficence. In this paper I will highlight an undesirable implication of this position: over-demandingness. After rejecting a prominent attempt to address this problem, I will then advance a virtue-ethical principle that adequately distinguishes the relevant duties and avoids over-demandingness. This principle links wrong actions to character by focusing on the vice of contempt for humanity. Here I will engage with Michael Slote’s (...) similar efforts, critiquing and improving upon them. This essay addresses a gap in the literature on positive duties by appealing to relevant virtue-ethical considerations from within a Neo-Aristotelian framework. (shrink)

My purpose in this paper is to show that current legal criteria for paternalistic involuntary psychiatric confinement of the mentally ill are both too narrow and too broad. I do this by first developing a principle of justified paternalistic interference with adults, which I take to be acceptably protective of individual liberty, but which does not require unnecessary sacrifices of individual welfare. After offering an analysis of current legal criteria for involuntary confinement, 1 argue that an acceptable theory of paternalistic (...) interference reveals that those criteria (1) exclude some cases where confinement would be morally permissible, and (2) allow paternalistic confinement of many whose detention is not morally justifiable. Keywords: paternalism, incompetence, involuntary civil confinement, liberty, beneficence, harm CiteULike Connotea Del.icio.us What's this? (shrink)