First we will discuss Case 15 and how it relates to issues of autonomy
I. Nonmaleficence- The notion of nonmaleficence is that one of a medical professional’s primary
duties is to do no harm to a patient or research subject. This seemingly simple principle is
actually very complex because there are many cases in which apparent harm leads to good, or in
which harming one patient could save others, etc. (consider Little Albert experiment).
A. We must contrast nonmaleficence with the principle of beneficence, which is the
subject of the next chapter. Beneficence is about actually helping people.
Nonmaleficence is about not harming them. There is no obvious way to rank one
obligation higher than the other, and which one takes priority will vary by situation.
B. As the book explains: “In general, if in a particular case the injury inflicted is very
minor, but the benefit provided is major, then we tend to think that” harming is OK
because of the greater good created. For example, we give people shots, which harms
them, but not much.
C. See pg. 115 for more about the difference, but the key point is that beneficence
involves taking action, while “nonmaleficence only requires
from actions that cause harm.” In other words, nonmaleficence tells us what
We can generally follow this principle by not acting. It calls on us to ask whether a
particular action would do more harm than good. If it would, we shouldn’t do it (again,
as a general rule). Compare this to positive and negative aspects of rights that we have
D. But what
harm? Technically speaking, we harm someone when we damage that
person in some way, but harming is not always the same as wronging another person.
We can harm a person without wronging him. I’ll give some examples, but this concept
is on pg. 116. How will we decide the difference? Usually, the intent is the key; I’ll
E. Many principles follow from the basic concept of nonmaleficence: Do not kill, do not
steal, etc. In fact, most of the basic moral rules you tend to think of when listing non-
controversial ethical claims fall under some version of “do not do X”.
F. However, there are cases where we do harm by
acting. This makes nonmaleficence
a bit more complicated than it first seems. As the book explains on 117: “Obligations of
nonmaleficence are not only obligations of not inflicting harms but also include
obligations of not imposing
of harm.” There are times when a person does not
directly intend to harm someone but is still morally responsible for a harm that befalls
that person. As a rule, we call this negligence. It happens when we are responsible for
caring for others. “Negligence is the absence of due care…” pg. 118. That whole quote
is important because it also explains two types of negligence.
G. Negligence is often related to liability. I’ll give some examples in class of how this