Beneficence is a concept in research ethics that states that researchers should have the welfare of the research participant as a goal of any

clinical trial Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, diet ...

or other research study. The antonym of this term, maleficence, describes a practice that opposes the welfare of any research participant. According to the

Belmont Report The ''Belmont Report'' is a report created by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Its full title is the ''Belmont Report: Ethical Principles and Guidelines for the Protection of Human ...

, researchers are required to follow two moral requirements in line with the principle of beneficence: do not harm and maximize possible benefits for research while minimizing any potential harm on others. The concept that medical professionals and researchers would always practice beneficence seems natural to most patients and research participants, but in fact, every

health intervention A public health intervention is any effort or policy that attempts to improve mental and physical health on a population level. Public health interventions may be run by a variety of organizations, including governmental health departments and ...

or research intervention has potential to harm the recipient. There are many different precedents in medicine and research for conducting a

cost–benefit analysis Cost–benefit analysis (CBA), sometimes also called benefit–cost analysis, is a systematic approach to estimating the strengths and weaknesses of alternatives. It is used to determine options which provide the best approach to achieving benefits ...

and judging whether a certain action would be a sufficient practice of beneficence, and the extent to which treatments are acceptable or unacceptable is under debate. Despite differences in opinion, there are many concepts on which there is wide agreement. One is that there should be community consensus when determining

best practices A best practice is a method or technique that has been generally accepted as superior to other known alternatives because it often produces results that are superior to those achieved by other means or because it has become a standard way of doing ...

for dealing with ethical problems.

Elements

These four concepts often arise in discussions about beneficence: #one should not practice evil or do harm, often stated in

Latin Latin (, or , ) is a classical language belonging to the Italic branch of the Indo-European languages. Latin was originally a dialect spoken in the lower Tiber area (then known as Latium) around present-day Rome, but through the power of the ...

as '' Primum non nocere'' #one should prevent evil or harm #one should remove evil or harm #one should practice good Ordinary moral discourse and most philosophical systems state that a prohibition on doing harm to others as in #1 is more compelling than any duty to benefit others as in #2–4. This makes the concept of "first do no harm" different from the other aspects of beneficence. One example illustrating this concept is the

trolley problem The trolley problem is a series of thought experiments in ethics and psychology, involving stylized ethical dilemmas of whether to sacrifice one person to save a larger number. The series usually begins with a scenario in which a runaway tram or ...

. Morality and ethical theory allows for judging relative costs, so in the case when a harm to be inflicted in violating #1 is negligible and the harm prevented or benefit gained in #2–4 is substantial, then it may be acceptable to cause one harm to gain another benefit. Academic literature discusses different variations of such scenarios. There is no objective evidence which dictates the best course of action when health professionals and researchers disagree about the best course of action for participants except that most people agree that the discussions about ethics should happen.

Problem

Some outstanding problems in discussing beneficence occur repeatedly. Researchers often describe these problems in the following categories:

To what extent should the benefactor suffer harm for the beneficiary?

Many people share the view that when it is trivial to do so, people should help each other. The situation becomes more complicated when one person can help another by making various degrees of personal sacrifice.

To whom are duties of beneficence owed?

Researchers should apply the concept of beneficence to individuals within the patient/physician relationship or the research-participant/researcher relationship. However, there is debate about the extent to which the interests of other parties, such as future patients and endangered persons, ought to be considered. When a researcher risks harm to a willing volunteer to do research with the intent to develop knowledge which will better humanity, this may be a practice of beneficence.

References

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