For the Patient's Good: The Restoration of Beneficence in Health Care

Beneficence - doing the right and good thing - is the fundamental principle of medical ethics. It points all medical decisions and actions toward advancing the patient's best interests. Yet in our normally pluralistic society where rights are asserted more frequently than obligations, this ancient principle tends to be obscured or confused with paternalism. This book attempts to rejuvenate and redevelop the notion of beneficence as a guiding principle within the ethics of medicine. The authors examine the content of the concept of 'patient good' from both philosophical and practical viewpoints, and they strive to supplement and in some ways transcend duty- and rights-based ethical systems. The book is divided into three sections. The first develops the authors' model of the doctor-patient relation as 'beneficence-in-trust'. The second examines the implications of the model for that relationship. The third explores some consequences of the beneficence model with respect to the difficult challenges facing health care, such as allocation of resources and decisions about incompetent patients. Like the authors' earlier work, A Philosophical Basis of Medical Practice (Oxford 1981), this book argues that the special nature of the doctor-patient relationship should be the primary source of the canons of professional medical ethics. It will be of value to physicians and ethicists as well as students of medicine and bioethics.