A summary of Chapter 5: Nonmaleficence.
Contains definitions as written in the book, often explicated/or debated in the summary or annotations.
(There also is a summary containing this chapter + chapters 1/4/6/7
The Principles of Biomedical Ethics (8th edition)
annotations are not derived from the book
Chapter 5: Nonmaleficence
“obligates us to abstain from causing harm to others”
The concept and principle of Nonmaleficence
Distinction between nonmaleficence and beneficence
Some philosophers combine the two; however if you do so you’ll acknowledge that there are several
obligations which underwrite different moral theories;
- Often nonmaleficence (no harm) is more stringent than beneficence (help), there are more
rules to not harming someone than to helping someone. And sometimes you’ll choose no
harm over helping and sometimes you’ll go the other way around, dependent on the
situation (nonmaleficence overrides beneficence); “even if the best utilitarian outcome
would be obtained by acting beneficently.
o Nonmaleficence sometimes overrides other principles (because it’s quite stringent),
but it depends on the situation if it does.; because it depends on the situation there
is no hierarchy in norms:
One ought not to inflect evil or harm (nonmaleficence)
One ought to prevent evil or harm (beneficence)
One ought to remove evil or harm (beneficence)
One ought to do or promote good (beneficence)
In these norms you can see the difference between the two principles. Whereas beneficence asks for
action by helping (preventing/removing/promoting), nonmaleficence asks for “intentional avoidance
of actions that cause harm”
The concept of harm
The concept of maleficence has been analyzed through the concepts of injury and harm;
Harm: “a harm is a thwarting, defeating, or setting back of some party’s interests, but a harmful
action is not always wrong or unjustified” – there are different ways to harm, you can wrong
someone which leads to a setback of someone’s interests (by violating someone’s rights). Or an
action has an adverse effect on someone’s interests, the latter meaning that action isn’t violating
anyone’s rights.
Negligence and the standard of due care
Nonmaleficence not only dictates an obligation not to inflict harms, but also an obligation to not
impose risks of harm.
- In case of a risk imposition there is a standard of “due care”, accepted both by law and
morality;
Due care: is “taking appropriate care to avoid causing harm, as the circumstances demand of
a reasonable and prudent person.” – in other words, the end justifies the means.
o It’s a specification of the principle and tells us whether the agent responsible for the
risk can be held accountable for it or not (whether the risk was justified).
o Negligence: when someone doesn’t follow the professional standards for due care
(when risks are allowed); there are two forms of negligence
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