THE PRINCIPLES OF BENEFICENCE AND NONMALEFICENCE
In ordinary language, the term beneficence (or sometimes called benevolence) indicates an obligation to "advance the most important interests of others and remove harms;" that is, to perform some acts of mercy, kindness and/or charity. Exercising beneficence can consist in either the provision of something good or the prevention of something bad. It is usually construed as a teleological principle calling upon us to increase pleasure and reduce pain in others. The principle of nonmaleficence (or, the harm principle) refers to the moral obligation not to harm others. Before we can make much sense of these fundamental principles, it is essential that we examine the two concepts that are a part of their common conceptual framework: that is, the concepts of interests and harms.
An interest is “anything we have a stake in” and usually identified with human needs. Obviously interests can be greater or lesser. In fact, philosophers often distinguish between mere wants (or desires) and interests (or needs). Although I may want a new electric guitar, to add to my collection, it’s not really an interest. Why? Because I am not really harmed if I do not get one! On the other hand, if I was a professional guitar player and my only guitar was broken, I’d have an interest in buying another one. Why” Because a guitar player without a guitar can’t make a living. (I have an interest in living!) Although there is a certain degree of subjectivity involved in drawing the line between wants and interests, we do all share a common set of interests. Generally speaking, we universally have an interest in staying alive; being relatively free of physical pain, being relatively free of disability, and we all have an interest in experiencing a certain amount of pleasure. Conversely, we all agree that death, pain, disability and loss of pleasure are harms, and that rational persons seek to avoid these states whenever possible. The principle of beneficence implies assisting others in securing their most important interests and removing harms. Hence, we are not under any moral obligation to help others secure mere wants or desires. So I don’t have to wash your car this weekend as an act of beneficence, but if you show up at my house hungry, I’ll gladly feed you! But it probably won’t be “surf and turf.”
Since some interests are greater than others, then obviously, some harms are greater than others. Rational human beings seek to avoid the risk of suffering immanent major harms by willingly risking lesser and/or improbable harms. For example, I got the flu shot this year. It hurt for a couple of days. It took about a half hour of my day that I could have spent reading or playing guitar. But it was a rational decision. Why? Who wants to be sick for two weeks? An irrational person, however, often risks high probability major harms, for reasons that most rational people do not find particularly convincing. Suppose I know that I get the flu every year but I refuse to get the shot because I’m afraid of needles. Is that a good reason? Is it irrational? Is it irrational for a person to knowingly have unprotected sex with a person infected with the AIDS virus? Hint: Does it make sense to risk contracting a deadly, highly contagious disease in order to experience a few seconds of intense pleasure?
The principle of nonmaleficence says that it morally wrong to harm others. That sounds simple enough, but it turns out to be rather complicated given the fact that assisting others often consists in the infliction of a lesser and/or improbable harm in order to avoid a major immanent harm. Hence, the best definition of nonmaleficence is probably the following: “Do not cause other persons to die, suffer pain or disability, or deprive them of their most important interests, unless you have a good reason.” You must also take into account the liberty principle.
In sum, all human beings take risks in order to realize their most important interests and avoid harms. Rational persons take into account the magnitude of the interests at stake and the probabilities of suffering harm. Irrational persons have unprotected sex with strangers and risk contracting a life-threatening disease, in order to experience a rather intense experience of pleasure for a few seconds. Now, given the fact that we are often confronted by individuals that find themselves in need, how much am I morally required to risk or sacrifice in order to fulfill the obligation of beneficence? Are there circumstances, for example, when I might be morally required to impoverish myself (and my family) in order to fulfill that obligation? Suppose that I meet a street person downtown, and discover that he/she is desperately in need of expensive dental work. Am I morally required to provide it, even if it means me taking out a loan? Am I a bad person if I do not help out?
In order to resolve this kind of moral dilemma, some philosophers differentiate between perfect duties and imperfect duties. Perfect duties are duties that are absolutely morally binding and require one specific action in order to be fulfilled. For example, I have a perfect duty not to unjustly kill other human beings. Imperfect duties are also absolutely binding, but their fulfillment is subject to our own individual circumstances and choices. Hence, in the case of the homeless person with a toothache, I could fulfill the requirements of beneficence by referring that person to an appropriate governmental agency; or, in the very least I might decide to buy him a bottle of Tylenol. If I were a successful dentist, I could choose to provide those services as an act of personal charity. It is also important to remember that it’s easier for us to exercise beneficence toward our relatives and friends, and more difficult to exercise it toward strangers. That’s why the major religious traditions teach us to “love thy neighbor.”
YOU MUST BE ABLE TO EXPLAIN THE FOLLOWING CONCEPTS?
Beneficence-
Harm-
Interests-
Nonmaleficence-
Perfect Duties-
Imperfect Duties-
Issue to Think About
Can you think of an example where an act of beneficence might conflict with the principle of utility?