test2b - First we will discuss Case 15 and how it relates...

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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 intentionally refraining from actions that cause harm.” In other words, nonmaleficence tells us what not to do. 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 already discussed. D. But what is 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 explain how. 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 not 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 risks 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
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This note was uploaded on 04/07/2008 for the course PHL 204 taught by Professor Sharp during the Spring '08 term at Alabama.

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test2b - First we will discuss Case 15 and how it relates...

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