Understanding Beneficence in Healthcare Ethics

When discussing the principle of beneficence, I see it as something primal: a mammalian desire to provide the best for those you care about. In healthcare, it is the patient; in families, it is the elderly or children; in communities, it is the ones who need support. Therefore, beneficence is inherent to human nature. Healthcare professionals use beneficence as the guiding principle in their professional decision-making. Having an innate desire to provide care that benefits the patient, including preventing harm, assisting individuals, and rescuing those in danger.  This principle emphasizes promoting welfare and fostering positive outcomes. This includes the physician’s responsibility to advocate for and provide the best care for their patients. The ethical approach of beneficence involves choosing a course of action that provides the necessary and appropriate care to the patient and their family.

In my opinion, the more open an individual is to new information, the more they engage with beneficence as an ethical principle. When an individual has an open mindset, they are usually more willing to engage with an individual. This ultimately leads to better management in care. An open-minded and unbiased approach is where ethical principles, such as beneficence, is best achieved. When providing care, the outcome of the care is as important as the intention. Although intention matters more when reviewing outcomes of actions, intention is how beneficence becomes involved. We use beneficence primarily when other aspects of our cognition aren’t flooded with unconscious biases and prejudices.

If unconscious factors mislead the decision-maker into unethical decision-making it is best that the physician be reviewed with the intent of ‘what’s best for them’, as only under these conditions does ethics thrive. In situations where safety and trust are established between the physician and authority, they will be more willing to engage in ethical decision-making, thus providing an individual approach to patient management.

The best approach to using beneficence is when other principles are respected. If beneficence is the physician’s only moral compass, then ethical mistakes can happen.

In certain scenarios, beneficence can result in hypocrisy when it fails to respect the patient’s autonomy or uphold justice. Globally, concerns about penalties from management have led physicians to refrain from disclosing information to patients; frequently, the reason for this is that family members are involved. Therefore, some medical communities have agreed that keeping the patient uninformed and the family satisfied is better than respecting the individual’s dignity and autonomy. If the patient is unaware and cannot make decisions, they are left to their families, who may not always have sound ethical reasoning. So, when the physician claims beneficence but withholds information, this creates an environment of distrust and thus, is non-beneficial.

In the dialogue of beneficence vs non-maleficence, there is the potential of a necessary course of action that could lead to violating the non-maleficence principle. In cases where treatment plans could compromise quality of life, weighing the benefits and harms of each course of action could compromise the non-maleficence principle. This is where I pivot back to autonomy and its importance for a healthy dynamic between healthcare providers and patients. It is where trust returns to the discourse. If there is no established trust between the two actors, it will increase the chances of causing more harm than necessary. In cases where the patient is autonomous and understands what they want from their treatment, their active participation in their health allows for more maleficent but beneficent therapies to be chosen based on the individual’s choice. If the principle of autonomy can not be executed, then the responsibility solely lies on the physician; this is where other ethical doctrines, such as the doctrine of double effect, can be applied to guide the physician in decision making.

In cases where beneficence conflicts with justice, the solution lies in the challenging task of establishing trust. As soon as this trust is based on a larger population scale, trust in the healthcare system is regained, and what was previously considered an unjust allocation of resources begins to be viewed as a necessity for all who require healthcare. When the focus of ethical principles remains on the security of human dignity, justice becomes a positive outcome of all the hours invested in moral decision-making.

The physician can begin a conscious approach to beneficence when they ask questions such as those proposed by the textbook ‘Doing Right’: “What can be done for the patient?” This way, the physician actively and consciously applies beneficence in practice. In other words, the same question could be asked: What is the most effective course of care for this individual based on my available information and resources? The outcome of treatment plans varies due to resource differences between regions. This has led to distrust in healthcare providers in areas where facilities are less equipped. The expectations of what a provider can do are unrealistic compared to what the available resources can achieve. The issue lies with the unjust distribution of resources within the healthcare system. Until this is addressed, the focus must be on establishing just relationships with limited resources by applying ethical principles in patient-physician interactions.

Beneficence is the foundation of moral reasoning and ethical decision-making. This principle makes one search for moral reasoning within oneself: the need for a better quality of life. When beneficence is recognized as a human quality and nurtured, it becomes the outcome of the chosen lifestyle. A desire for a higher quality of life will ultimately lead to searching for a better approach to one’s life. This involves improving relationships and connections by providing a better-quality approach to these relationships. Using the principle of beneficence, the quality of relationships begins to improve, most importantly, the patient-physician relationship.