Beneficence is a foundational ethical principle in medicine. To provide benefit to a patient is to promote and protect the patient’s wellbeing, to promote the patient’s interests. But there are different conceptions of wellbeing, emphasizing different values. These conceptions of wellbeing are contrary to one another and give rise to dissimilar ideas of what it means to benefit a patient. This makes the concept of beneficence ambiguous: is a benefit related to the patient’s goals and wishes, or is (...) it a matter of objective criteria that constitute wellbeing? This paper suggests a unified conception of wellbeing for use in medicine to determine what counts as a benefit. Two components of wellbeing are identified: (1) objective functioning/health and (2) the patient’s view of her own good. The paper explores how to apply, balance, and weigh these components in clinical situations to determine what counts as a benefit to a patient. (shrink)

Consider a duty of beneficence towards a particular individual, S, and call a reason that is grounded in that duty a “beneficence reason towards S.” Call a person who will be brought into existence by an act of procreation the “resultant person.” Is there ever a beneficence reason towards the resultant person for an agent to procreate? In this paper, I argue for such a reason by appealing to two main premises. First, we owe a pro tanto (...) duty of beneficence to future persons; and second, some of us can benefit some of those persons by procreating. In support of the first premise I reject the presentist account of time in favor of the view that future persons are just as real as presently existing persons. I then argue that future persons are like us in all the morally relevant ways, and since we owe duties of beneficence to each other, we also owe duties of beneficence to future persons. In support of the second premise I offer an account of benefiting according to which an individual can be benefited by an action even if it makes her no better off than she would have been, had the action not been performed. This account of benefiting solves what I call the “non-identity benefit problem.” Finally, I argue that having a life worth living is a benefit, and some of us can cause some persons that benefit by causing them to exist. (shrink)

This article considers the way beneficence was treated in an important journal toward the end of the Old Regime. It finds that the Journal de Paris during the years 1783 and 1784 not only publicized acts of beneficence, but also mediated between members of the public who, on their own initiative, contributed to those in need and officials and organizations which in practice cared for the disadvantaged, especially a committee that freed prisoners for debts to wet nurses and (...) the Société philanthropique of Paris. While the notion of beneficence has sometimes been found to offer a secularized version of the traditional value of charity, this article finds that in practice religious and secular people worked together to support those they deemed worthy of aid. The relation of beneficence to self-interest is also considered, and it is suggested that the initiatives of the better-off members of civil society rather than government opened the way toward something approaching a welfare state. (shrink)

Recently, Julian Savulescu and Guy Kahane have defended the Principle of Procreative Beneficence (PB), according to which prospective parents ought to select children with the view that their future child has ‘the best chance of the best life’. I argue that the arguments Savulescu and Kahane adduce in favour of PB equally well support what I call the Principle of General Procreative Beneficence (GPB). GPB states that couples ought to select children in view of maximizing the overall expected (...) value in the world, not just the welfare of their future child. I further argue that Savulescu and Kahane's claim that PB has significantly more weight than competing moral principles, such as GPB, lacks justification. A possible argument for PB having significant weight builds on a principle of parental partiality towards one's own children. But this principle does not support PB; it supports a Principle of Sibling-Oriented Procreative Beneficence (SPB), according to which parents selecting a child should maximize the benefit of all their children. Indeed, PB itself will in some cases be self-effacing in favour of SPB. (shrink)

This article considers the way beneficence was treated in an important journal toward the end of the Old Regime. It finds that the Journal de Paris during the years 1783 and 1784 not only publicized acts of beneficence, but also mediated between members of the public who, on their own initiative, contributed to those in need and officials and organizations which in practice cared for the disadvantaged, especially a committee that freed prisoners for debts to wet nurses and (...) the Société philanthropique of Paris. While the notion of beneficence has sometimes been found to offer a secularized version of the traditional value of charity, this article finds that in practice religious and secular people worked together to support those they deemed worthy of aid. The relation of beneficence to self-interest is also considered, and it is suggested that the initiatives of the better-off members of civil society rather than government opened the way toward something approaching a welfare state. (shrink)

A background assumption in much contemporary political philosophy is that justice is the first virtue of social institutions, taking priority over other values such as beneficence. This assumption is typically treated as a methodological starting point, rather than as following from any particular moral or political theory. In this paper, I challenge this assumption. To frame my discussion, I argue, first, that justice doesn’t in principle override beneficence, and second, that justice doesn’t typically outweigh beneficence, since, in (...) institutional contexts, the stakes of beneficence are often extremely high. While there are various ways one might resist this argument, none challenge the core methodological point that political philosophy should abandon its preoccupation with justice and begin to pay considerably more attention to social beneficence—that is, to beneficence understood as a virtue of social institutions. Along the way, I also highlight areas where focusing on social beneficence would lead political philosophers in new and fruitful directions, and where normative ethicists focused on personal beneficence might scale up their thinking to the institutional case. GPI Working Paper No. 11-2022. (shrink)

ABSTRACTIn 2001, Julian Savulescu wrote an article entitled ‘Procreative Beneficence: Why We Should Select the Best Children’, in which he argued for the genetic selection of intelligence in children. That article contributes to a debate on whether genetic research on intelligence should be undertaken at all and, if so, should intelligence selection be available to potential parents. As such, the question of intelligence selection relates to wider issues concerning the genetic determination of behavioural traits, i.e. alcoholism. This article is (...) designed as an engagement in the intelligence selection debate using an analysis of Savulescu's arguments to raise a series of problematic issues in relation to the ethics of parental selection of intelligence. These problematic issues relate to wider assumptions that are made in order to put forward intelligence selection as a viable ethical option. Such assumptions are more generic in character, but still relate to Savulescu's article, concerning issues of genetic determinism, private allocation and inequality, and, finally, individual versus aggregate justice. The conclusion focuses on what the implications are for the question of agency, especially if intelligence selection is allowed. (shrink)

This article critically analyzes the principle of beneficence and the principle of nonmaleficence in clinical medical ethics. It resists some recent skepticism about the principle of nonmaleficence, and then seeks to explain its role in medicine. The article proposes that the two principles are informed by different accounts of what is in the patient’s best interests. The principle of beneficence is tied to the patient’s best overall interests, whereas the principle of nonmaleficence is tied to the patient’s best (...) medical interests only. The article argues that the principle of nonmaleficence takes priority over the principle of beneficence in that it filters the treatment options that are appropriately subject to the principle of beneficence. Understanding how both principles can play an important role in medical practice, and how they relate when they come into conflict, can help clinicians to avoid certain mistakes in thinking about their duties to their patients. (shrink)

This paper argues that societal duties of health promotion are underwritten (at least in large part) by a principle of beneficence. Further, this principle generates duties of justice that correlate with rights, not merely “imperfect” duties of charity or generosity. To support this argument, I draw on a useful distinction from bioethics and on a somewhat neglected approach to social obligation from political philosophy. The distinction is that between general and specific beneficence; and the approach from political philosophy (...) has at times been called equality of concern. After clarifying the distinction and setting out the basis of the equality of concern view, I argue that the result is a justice-based principle of “specific” beneficence that should be reflected in a society’s health policy. I then draw on this account to criticize, refine, and extend some prominent health care policy proposals from the bioethics literature. (shrink)

The Principle of Procreative Beneficence (PB) holds that when a couple plans to have a child, they have significant moral reason to select, of the possible children they could have, the child who is most likely to experience the greatest wellbeing – that is, the most advantaged child, the child with the best chance at the best life.1 PB captures the common sense intuitions of many about reproductive decisions. PB does not posit an absolute moral obligation – it does (...) not dictate what people must do. Instead it holds that there is a significant moral reason to select the best child, but one that must be weighed against other reasons.Recent research suggests that it may become possible to derive gametes (eggs and sperm) from human stem cells in vitro, a process which we will term in vitro gametogenesis (IVG). The ability to create large numbers of eggs or sperm through IVG greatly increases our capacity to select the best child possible. (shrink)

Euthanasia has once again become headline news in the UK, with the announcement by Dr Michael Irwin, a former medical director of the United Nations, that he has helped at least 50 people to die, including two between February and July 1997. He has been quoted as saying that his ‘conscience is clear’ and that the time has come to confront the issue of euthanasia. For the purposes of this article, the term ‘beneficent voluntary active euthanasia’ (BVAE) will be used: (...) beneficent from the prima facie principle of beneficence, to do good, and voluntary to indicate that this must be carried out at the request of a competent client. This implies adherence to another prima facie principle, that of respect for autonomy. Active implies that something is done or given with the intention of hastening death. The word euthanasia itself simply means ‘good death’. This article examines the moral positions of two nurses and one junior doctor towards the subject of BVAE and an attempt is made to represent the main conflicting moral positions. The central arguments against BVAE and counterarguments are presented. The conclusion reached is that consenting adults should not be prevented from availing themselves of BVAE if another consenting adult (a medical doctor) is available and capable of carrying out their wishes. This being the case, it is suggested that BVAE should be available as an option in hospices and in the community. The aims of this article are: to generate debate among professionals; to present a three-way discussion that might be useful as a focus for educational purposes, particularly at undergraduate level; to challenge professionals to confront the issue of euthanasia; and to plead the case of those who request assistance in exercising autonomy by gaining control over their own deaths. (shrink)

This chapter contains section titled: I II III Acknowledgement.

When it comes to the duty of beneficence, a formidable class of moderate positions holds that morally significant considerations emerge when one's actions are seen as part of a larger series. Agglomeration, according to these moderates, limits the demands of beneficence, thereby avoiding the extremely demanding view forcefully defended by Peter Singer. This idea has much appeal. What morality can demand of people is, it seems, appropriately modulated by how much they have already done or will do. Here (...) we examine a number of recent proposals that appeal to agglomeration. None of them, we argue, succeeds. (shrink)

This chapter contains sections titled: The Obligatory Ends Anti‐paternalism and the Duty of Beneficence Beneficence: The Finer Points The Question of Latitude Latitude and (Im)partiality Gratitude Sympathy Conclusion Bibliography.

This article explores the motives underlying corporate responses to the COVID-19 pandemic. The analysis begins with Thomas Dunfee’s Statement of Minimum Moral Obligation (SMMO), which specifies, more precisely than any other contribution to the business ethics canon, the level of corporate beneficence required during a pandemic. The analysis then turns to Milton Friedman’s neoliberal understanding of human nature, critically contrasting it with the notion of stoic virtue that informs the works of Adam Smith. Friedman contends that beneficence should (...) play no role in corporate settings. Smith, by contrast, emphasizes the need for prudence, beneficence and self-command in all human endeavours. The article then uses these competing frameworks to reflect on a published survey of 145 corporate responses to COVID-19. In many of these responses, the benefit to a non-financial stakeholder is clear, while the financial consequence to the firm remains nebulous. This supports the contention that during a pandemic, beneficence provides a more complete explanation of many corporate actions than the profit motive alone. The article contests Friedman’s Chicago School profit imperative and goes beyond Dunfee’s SMMO by endorsing the more full-throated embrace of beneficence and stoic virtue found in the works of Smith. (shrink)

In chapter 3 of Wild Animal Ethics Johannsen argues for a collective obligation based on beneficence to intervene in nature in order to reduce the suffering of wild animals. In the same chapter he claims that the non-identity problem is merely a “theoretical puzzle” which doesn’t affect our reasons for intervention. In this paper I argue that the non-identity problem affects both the strength and the nature of our reasons to intervene. By intervening in nature on a large scale (...) we change which animals come into existence. In doing so, we enable harmful animals to inflict harms on other animals, and we put other animals in harm’s way. The harms that these animals will inflict and endure are foreseeable. Furthermore, since non-human animals aren’t moral agents, harmful animals cannot be morally responsible for their harmful actions. I argue therefore that by causing animals to exist, knowing that they will inflict and suffer harms, we become morally responsible for those harms. By engaging in identity-affecting actions then we take on secondary moral duties towards the animals we have thereby caused to exist, and these secondary moral duties may be extremely demanding, even more so than the initial costs of intervention. Finally, these duties are duties of justice rather than duties of beneficence, and as such are more stringent than purely beneficence-based moral reasons. Furthermore, this conclusion flows naturally from several plausible principles which Johannsen explicitly endorses. (shrink)

Common sense tells us that in certain circumstances, helping someone is morally obligatory. That intuition appears incompatible with Kant's account of beneficence as a wide imperfect duty, and its implication that agents may exercise latitude over which beneficent actions to perform. In this paper, I offer a resolution to the problem from which it follows that some opportunities to help admit latitude and others do not. I argue that beneficence has two components: the familiar wide duty to help (...) others achieve their ends and a narrow duty to avoid indifference to others as end-setters. Although we are not always required to help, we are always required not to be indifferent. When helping someone is the only way not to be indifferent to a person, helping him/her is obligatory. My account avoids certain difficulties with other proposed solutions and can also address an important concern about proximity. (shrink)

Some philosophers claim that there is no morally relevant distinction to be made between duties of rescue and beneficence. In this paper I will highlight an undesirable implication of this position: over-demandingness. After rejecting a prominent attempt to address this problem, I will then advance a virtue-ethical principle that adequately distinguishes the relevant duties and avoids over-demandingness. This principle links wrong actions to character by focusing on the vice of contempt for humanity. Here I will engage with Michael Slote’s (...) similar efforts, critiquing and improving upon them. This essay addresses a gap in the literature on positive duties by appealing to relevant virtue-ethical considerations from within a Neo-Aristotelian framework. (shrink)

Beneficence is usually regarded as adequate when it results in an actual benefit for a beneficiary and satisfies her self-chosen end. However, beneficence that satisfies these conditions can harm beneficiaries' free agency, particularly when they are robustly dependent on benefactors. First, the means that benefactors choose can have undesirable side-effects on resources that beneficiaries need for future free action. Second, benefactors may undermine beneficiaries' ability to freely deliberate and choose. It is therefore insufficient to satisfy someone's self-chosen ends. (...) Instead, good beneficence depends on whether the benefactor avoids undue influence over a beneficiary's deliberation and whether the choice of means is compatible with the beneficiary's conception of her good. Consequently, benefactors must have substantial respect for a beneficiary's free agency and the practical competence to choose means that take into account the beneficiary's conception of her good and the wider set of circumstances that influence her life. (shrink)

Imagine a world where everyone is healthy, intelligent, long living and happy. Intuitively this seems wonderful albeit unrealistic. However, recent scienti c breakthroughs in genetic engineering, namely CRISPR/Cas bring the question into public discourse, how the genetic enhancement of humans should be evaluated morally. In 2001, when preimplantation genetic diagnosis (PGD) and in vitro fertilisation (IVF), enabled parents to select between multiple embryos, Julian Savulescu introduced the principle of procreative bene cence (PPB), stating that parents have the obligations to choose (...) the child that is expected to have the best life. In this paper I argue that accepting the PPB and the consequentialist principle (CP) that two acts with the same consequences are morally on par, commits one to accepting the parental obligation of genetically enhancing one's children. (shrink)

A relevant problem in reproductive ethics is the moral evaluation of selection of the possible children that the parents can have. This article discusses one of the main attempts to solve this problem, the principle of Procreative Beneficence proposed by Julian Savulescu to define a strong pro-selection perspective. According to Savulescu, such a principle has an impersonal form and is balanced with a person-affecting principle of harm. The article proposes a new person-affecting interpretation of Procreative Beneficence, distinguishing it (...) from other pro-selection views and exploring its extension beyond selection to other problems of reproductive ethics. (shrink)

(2002). Therapeutic Beneficence and Patient Recruitment in Randomized Controlled Clinical Trials. The American Journal of Bioethics: Vol. 2, No. 2, pp. 35-36.

Kantian responses to three related questions are considered: Given the limits of our altruistic sentiments, is it possible for us to act beneficently as duty seems to require? What are we morally required to do for others besides respecting their rights? Why is this a reasonable requirement? Although the importance of empirical facts in deliberation is undeniable, the distinction between a practical deliberative point of view and the perspective of empirical inquiry proves to be crucial. Kant's grounds for an imperfect (...) duty of beneficence are examined. From a deliberative perspective, we must assume that we can act beneficently, even when lacking altruistic sentiments, provided we understand the good reasons for doing so. (shrink)

It is plausible to think that it is wrong to cure many people’s headaches rather than save someone else’s life. On the other hand, it is plausible to think that it is not wrong to expose someone to a tiny risk of death when curing this person’s headache. I will argue that these claims are inconsistent. For if we keep taking this tiny risk then it is likely that one person dies, while many others’ headaches are cured. In light of (...) this inconsistency, there is a conflict in our intuitions about beneficence and chance. This conflict is perplexing. And I have not been able to find a satisfactory way of resolving it. Perhaps you can do better? (shrink)

Effective Altruism is a movement and a philosophy that has reinvigorated the debate about the nature of beneficence. At base, it is the consistent application of microeconomic principles to beneficent action. The movement has exposed that many forms of giving do little good (or do active harm), but others do tremendous good. Questioning Beneficence uses Effective Altruism as a launchpad to ask hard questions about beneficence more generally. Must we be Effective Altruists, or is Effective Altruism and (...) the ideas driving the movement a mistake? How much should we give and-if anything-how should we give it? What are the respective roles of different kinds of institutions? Is charity anti-democratic and do billionaire philanthropists have too much power? Is Effective Altruism just utilitarianism in disguise? Questioning Beneficence is written by four philosophers, each with distinct points of view. It introduces a new standard for debating ideas in philosophy as each author poses and answers three questions and each of his three co-authors responds to those questions in turn. Finally, the first author replies to his co-authors' responses. Throughout the book, there is a spirit of curiosity, intellectual risk taking, and truth-seeking, rather than point-scoring and one-upsmanship. Questioning Beneficence demonstrates what open-minded, real dialogue over an important issue can be at its very best. (shrink)

In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has (...) an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society’s medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice. (shrink)

This paper explores the importance of hope as a determining factor for patients to participate in first-in-human trials for synthetic biology therapies. This paper focuses on different aspects of hope in the context of human health and well-being and explores the varieties of hope expressed by patients. The research findings are based on interview data collected from stable gout and diabetes patients. Three concepts of hope have emerged from the interviews: hope as certainty ; hope as reflective uncertainty ; hope (...) as self-therapy. The purpose of the paper is twofold. First, it aims to underline the significance of hope in patients’ medical decision-making, as well as the beneficence of hope for patients’ well-being, and for progress in research. Second, it shows how philosophical investigations—in particular Descartes—explore the phenomenon of hope and provide medical empirical research with profitable insights and tools. (shrink)

Procreative Beneficence (PB) states that couples should have “the best child” they can, that means, they have a moral obligation to select the child, that “can be expected to enjoy the most well-be...

Meaningful work is a key element of positive functioning of employees, but what makes work meaningful? Based on research on self-determination theory, basic psychological needs, and prosocial impact, we suggest that there are four psychological satisfactions that substantially influence work meaningfulness across cultures: autonomy (sense of volition), competence (sense of efficacy), relatedness (sense of caring relationships), and beneficence (sense of making a positive contribution). We test the relationships between these satisfactions and perceived meaningful work in Finland (n = 594, (...) employees of several organizations), India (n = 342, collected through Mturk), and the USA (n = 373, collected through Mturk). Regression analyses show that – except for competence in USA – all four satisfactions are significantly and independently associated with meaningful work. Moreover, structural equation modeling shows that they fully mediated the relationship between occupational position and work meaningfulness in India and in the USA. In sum, the results support the importance of these four satisfactions in explaining the psychological underpinnings of meaningful work. (shrink)

Is implementing the beneficent nudge program morally permissible in worlds like ours? I argue that there is reason for serious doubt. I acknowledge that beneficent nudging is highly various, that nudges are in some circumstances morally permissible and even called for, and that nudges may exhibit respect for genuine autonomy. Nonetheless, given the risk of epistemic injustice that nudges typically pose, neither the moral permissibility of beneficent nudging in the abstract, nor its case-by-case vindication, appears sufficient to justify implementing a (...) nudge program in worlds like ours. Drawing on Miranda Fricker’s account of epistemic injustice, I argue that the cogent defense of any nudge program, relative to worlds like ours, stands in need of serious attention to its potential for fostering or sustaining epistemic injustice. A more specific point hinges on recognizing a form of epistemic injustice not enough attended to in the literature to date, which I call reflective incapacitational injustice. This includes relative disadvantages in the attaining of the capacity to engage in critical reason, such as the capacity to go in for potentially critical reasoned deliberation and discursive exchange concerning ends. Since Cass Sunstein’s First Law of behaviorally informed regulation would be taken, in worlds like ours, to justify indeterminately many nudges leading to such epistemic injustice we have general grounds for doubting the moral permissibility of this nudge program. We should hence oppose the implementation of any such program until it is shown not to violate the demands of epistemic justice. (shrink)

Julian Savulescu has given clear expression to a principle—that of “procreative beneficence”—which underlies the thought of many contemporary writers on bioethics. The principle of procreative beneficence holds that parents or single reproducers are at least prima facie obliged to select the child, out of a range of possible children they might have, who will be likely to lead the best life. My aim in this paper is to argue that prospective parents, just by dint of their being prospective (...) parents, are in fact not obliged to act on PPB. That is, there is something about their filling the role of prospective parents that exempts them from selecting the child with the best life. I urge that it is more realistic to view prospective parents as bound by a principle of acceptable outlook, which holds that they ought not to select children whose lives will contain an unacceptable amount of suffering. (shrink)

In this paper, I present briefly a view about intrinsic value, one connected to the concepts of ethically required attitudes of favor, disfavor, and preference. If lives can have both welfare value and intrinsic value, how are these values related? I defend the view that the welfare value of a life does not track the intrinsic value of that life. Some philosophers, however, deny that anything can have intrinsic value or absolute value. Some argue that to hold that something is (...) both bad for a person and bad simpliciter leads to an objectionable double counting. Others hold views that would, if true, diminish the practical importance of intrinsic value. Some hold that our relations with others should not be guided by what is intrinsically good or bad, but only by what is good or bad for someone. Others hold that the concepts of love, benefit, and harm are tied exclusively to welfare value or well-being. Still others suggest that the moral principles of beneficence and non-maleficence are tied exclusively to welfare and well-being. I argue that these views are mistaken. In this regard, I attempt to defend the practical importance of intrinsic value. (shrink)

Beneficence is one of the four principles that form the basis of the Australian National Statement. The aim of this paper is to explore the philosophical development of this principle and to clarify the role that beneficence plays in contemporary discussions about human research ethics. By examining the way that guidance documents, particularly the National Statement, treats beneficence we offer guidance to researchers and human research ethics committee members on the practical application of what can be a (...) conceptually difficult principle. (shrink)

The prevailing discourse around AI ethics lacks the language and formalism necessary to capture the diverse ethical concerns that emerge when AI systems interact with individuals. Drawing on Sen and Nussbaum’s capability approach, we present a framework formalizing a network of ethical concepts and entitlements necessary for AI systems to confer meaningful benefit or assistance to stakeholders. Such systems enhance stakeholders’ ability to advance their life plans and well-being while upholding their fundamental rights. We characterize two necessary conditions for morally (...) permissible interactions between AI systems and those impacted by their functioning, and two sufficient conditions for realizing the ideal of meaningful benefit. We then contrast this ideal with several salient failure modes, namely, forms of social interactions that constitute unjustified paternalism, coercion, deception, exploitation and domination. The proliferation of incidents involving AI in high-stakes domains underscores the gravity of these issues and the imperative to take an ethics-led approach to AI systems from their inception. (shrink)

This chapter examines the explicit and implicit roles that the concept of beneficence plays in the guidelines that govern biomedical research involving humans. We suggest that the role beneficence is actually playing in the guidelines is more comprehensive than is commonly assumed. The broader conceptualisation of beneficence proposed here clarifies the relationship of beneficence to respect for autonomy. It does this by showing how respect for autonomy is at the service of beneficence rather than in (...) tension with it. (shrink)

The patient’s autonomy and well-being are sometimes seen as central to the ethical justification of voluntary euthanasia (VE) and physician-assisted suicide (PAS). While respecting the patient’s wish to die plausibly promotes the patient’s autonomy, it is less obvious how alleviating the patient’s suffering through death benefits the patient. Death eliminates the subject, so how can we intelligibly maintain that the patient’s well-being is promoted when she/he no longer exists? This article interrogates two typical answers given by philosophers: (a) that death (...) confers a well-being benefit in the sense that it actualises a comparatively better life course for the patient (ie, a shorter life with less net suffering), and (b) that death is beneficial because non-existence which entails no suffering is superior to an existence filled with suffering. A close examination of the two senses in which the patient might incur a well-being benefit reveals problems that preclude physicians delivering VE/PAS in the name of beneficence. (shrink)

I begin with a note about moral goodness as a quality, disposition, or trait of a person or human being. This has at least two different senses, one wider and one narrower. Aristotle remarked that the Greek term we translate as justice sometimes meant simply virtue or goodness as applied to a person and sometimes meant only a certain virtue or kind of goodness. The same thing is true of our word “goodness.” Sometimes being a good person means having all (...) the virtues, or at least all the moral ones; then goodness equals the whole of virtue. But sometimes, being a good person has a narrower meaning, namely, being kind, generous, and so forth. Thus, my OED sometimes equates goodness with moral excellence as a whole and sometimes with a particular moral excellence, viz., kindness, beneficence, or benevolence; and the Bible, when it speaks of God as being good sometimes means that God has all the virtues and sometimes only that he is kind, mereiful, or benevolent. When Jesus says, “Why callest thou me good: None is good, save one, that is God,” he seems to be speaking of goodness in the inclusive sense, but when the writer of Exodus has God himself say that he is “merciful and gracious, long-suffering, and abundant in goodness and truth,” God is using “goodness” in the narrower sense in which it means benevolence, for he goes on to make it clear that he is also just and severe. Similarly, “good will” may mean either “morally good will” in general, as it does in Kant, or it may mean only “benevolent will,” as it usually does; in “men of good will” it is perhaps ambiguous. (shrink)

What are we morally required to do for strangers? To answer this question – a question about the scope of requirements to aid strangers – we must first answer a question about justification: why are we required to aid them (when we are)? The main paper focuses largely on answering the question about justification, but does so in order to arrive at an answer to the question about scope. Three main issues are discussed. First, to what extent should requirements of (...) beneficence – requirements to benefit other people – be seen as generated by people’s rights to receiving aid? Secondly, what is the relationship between requirements of beneficence that apply to us collectively and requirements of beneficence that apply to each of us individually? According to Liam Murphy, our obligations to help distant strangers are fundamentally collective obligations, and any individual obligations we bear are consequently obligations to discharge our “fair share” of these collective obligations. I shall argue that, on the contrary, there are large-scale collective obligations of beneficence that derive from more fundamental individual obligations. My third issue concerns the moral significance of citizenship. What morally relevant difference is there between strangers who are compatriots and those who are not? (shrink)

The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research published in March of 1983 its Report, Securing Access to Health Care: The Ethical Implications of Differences in the Availability of Health Services . Concluding that there are "ethical obligations" on behalf of society which are balanced by individual obligations, the Report provides an ethical framework for ensuring "ultimate responsibility" of the Federal government to arrange for equitable access to health and to a fair (...) share of cost. In doing so the Report neither makes justice nor beneficence the prime moral principle in public health care, it rather calls for a common sense approach in "approximating adequacy". But how to define equality without creating uniformity in a society rich in its diversity, including attitudes towards health? Keywords: justice, beneficence, right to health care, equality, distribution CiteULike Connotea Del.icio.us What's this? (shrink)

I argue for three principles of minimal beneficence, which constrain when and what at least we are obligated to do on behalf of someone. All three may be accepted by both the consequentialist Peter Singer and by his staunch opponents in material value-ethics, who are typically anti-consequentialists. Either side would philosophically benefit from accepting the principles. At the same time, the first principle is rarely applicable, the second only when the available relevant evidence is not too complex, and the (...) third only as a prompt to keep thinking seriously about how to practice beneficence. Even so, I derive some widely applicable, practical implications. (shrink)

The argument of Julian Savulescu’s 2001 paper, “Procreative Beneficence: Why We Should Select the Best Children” is flawed in a number of respects. Savulescu confuses reasons with obligations and equivocates between the claim that parents have some reason to want the best for their children and the more radical claim that they are morally obligated to attempt to produce the best child possible. Savulescu offers a prima facie implausible account of parental obligation, as even the best parents typically fail (...) to do everything they think would be best for their children let alone everything that is in fact best for their children. The profound philosophical difficulties which beset the attempt to formulate a plausible account of the best human life constitute a further independent reason to resile from Savulescu’s conclusion. Savulescu’s argument also requires parents to become complicit with racist and homophobic oppression, which is yet another reason to reject it. Removing the equivocation from Savulescu’s argument allows us to see that the assertion of an obligation to choose the “best child” has much more in common with the “old” eugenics than Savulescu acknowledges. (shrink)

According to Peter Singer, virtually all of us would be forced by adequate reflection on our own convictions to embrace a radical conclusion about giving. The following principle, he says, is “surely undeniable” -- at least once we reflect on secure convictions concerning rescue, as in his famous case of the drowning toddler.

Rashad Rehman, Nipa Chauhan and Rebecca Greenberg argue that beneficent paternalism should be integrated into shared decision-making in the NICU to maximize the patient’s best interests.

This article deals with a discussion of Savulescu’s impersonal version of the Principle of Procreative Beneficence and its relationship with a person-affecting Principle of Harm in order to evaluate the cases of selection of which child to have. It aims to show some problems in Savulescu’s attempt to arrange the two principles (the conflict between beneficence and harm, the limitation of beneficence to pre-conception selection, the extension of beneficence to different quantity people choice), and to propose (...) an alternative version of Procreative Beneficence (a narrow person-affecting version), in order to avoid these problems. (shrink)

What, if anything, are we morally required to do on behalf of others besides respecting their rights? And why is such regard for others a reasonable moral requirement? These two questions have long been major concerns of ethical theory, but the answers that philosophers give tend to vary with their beliefs about human nature. More specifically, their answers typically depend on the position they take on a third-question: To what extent, if any, is it possible for us to act altruistically?

This chapter asks what stance is morally appropriate as we consider when, whether, and how to assist persons experiencing physical, emotional, or intellectual disability. Appealing to a variety of intelligent and observant thinkers for inspiration (Ralph Barton Perry, Helen Keller, and Immanuel Kant), it argues that one important aspect of such a stance is an attitude of reciprocal beneficence. This has three central aspects: a perspective of fellowship acknowledging the disabled and the currently able as members of the community (...) of vulnerable human agents; a developed sympathy attuned to gaps in knowledge and failures of imagination and analogy; and a readiness to show gratitude or appreciation for what the currently disabled may teach about the vulnerable moral agency we share. The argument takes initial inspiration from Perry but owes most to its roots in Kantian moral and political theory. It also owes much to wise and insightful enrichments due to Keller. (shrink)