Beneficence Health Article

BENEFICENCE

In public health, the governing ethical theory is utilitarianism, meaning "doing the greatest good for the largest number of people." Beneficence is strongly tied to the utilitarian theory of ethics. It is one of four principles considered in medicine and public health under the principle-based approach to ethical analysis. The other three principles are: respect for autonomy, nonmaleficence, and distributive justice. Beneficence is the professional duty to do or produce good. By "good" is meant the performance of acts of kindness and charity. "Doing good" is considered virtuous conduct. Ultimately, beneficence is the duty to do more good than harm through public health actions because, in practice, no action in public health will have exclusively beneficial effects. For example, if a public health agency becomes aware of a person infected with a bacterium that could be spread through the air, then, there is, on the one hand, a duty to respect the person's right to confidentiality and freedom of movement. But, on the other hand, there is a greater duty to prevent the spread of the bacterium to other people. Thus, more good would be achieved by protecting the public health, which can be accomplished only by breaching the duty to maintain the infected person's confidentiality and freedom of movement. Such breaches would occur only to reduce the risk associated with permitting the infectious person to put others at risk of infection (e.g., through quarantine or confinement, with a consequent loss of privacy in terms of the diagnosis). The ethical dilemma for decision makers in public health lies in weighing the pros and cons between at least two conflicting options: protecting the individual's rights or protecting the public health. Such breaches of an individual's rights are rare in public health and are undertaken only with maximum discretion.

COLIN L. SOSKOLNE

(SEE ALSO: Autonomy; Ethics of Public Health; Nonmaleficence; Paternalism)

BIBLIOGRAPHY

Beauchamp T. L., and Childress, J. F. (1994). Principles of Biomedical Ethics, 4th edition. New York: Oxford University Press.