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Beneficence

In this series of articles, medical students from across the country will discuss a range of topics from medical ethics to the NHS to public health to medical conditions to clinical governance.

The beneficence pillar of medical ethics is to “do good”. It is derived from the Latin word benefactum, meaning "good deed." The ethical pillar refers to the moral requirement of medical professionals to act in what they believe is their patients best interests at all times. For example, doctors should be able to identify which available evidence-based treatment would give their patient the best outcome.

Acting holistically

In order to act in your patients best interests, as a doctor you should consider a variety of factors, such as your patients expectations of treatment and their personal circumstances. This approach is known as patient-centric or holistic care. To “do good” when ranking treatment options for your patient from a variety of different treatment plans, the chosen treatment should be medically “good” for the patient, but also suit the patient's individual circumstances. Therefore, beneficence without respect for an individual's autonomy (their wishes) may lead to actions that are not really beneficial as they try to promote their well‐being against their will.

For example, in an athlete with an injury, the physician should recognise and incorporate their patients goals and values and present treatment options that do not necessarily hinder athletic success to the shared decision making process.

Physician assisted suicide: How does the pillar of beneficence apply to this?

Physician assisted suicide is defined as suicide by a patient facilitated by means (such as a drug prescription) or by information (such as an indication of a lethal dosage) provided by a physician aware of the patient's intent to relieve suffering.

Assisted suicide is illegal under the terms of the Suicide Act (1961) and is punishable by up to 14 years' imprisonment.

Physician assisted suicide is a deeply complex topic with a variety of factors that need to be considered, with the ethical pillar of beneficence being one. Although beneficence requires a physician to act in the best interests of their patients, there is rightly controversy over what courses of action a physician should take to properly fulfill this duty.

Some people believe that in order to “do good”, a physician should always aim to preserve life. In the case of a suffering terminally ill patient who is asking to end their life, they believe that it would be morally wrong to not let the disease take its natural course. They believe that everything possible should be done to make the patient more comfortable and prolong the time that the patient has with their friends and family.

Others argue that in order to “do good” a patient's best interests are best served by a doctor who respects their patient's autonomy, empathises with the pain that they are suffering, and is willing to take action to end that pain. Again, in the case of a suffering terminally ill patient who is asking to end their life, they believe that ending the patient’s life in a merciful and dignified way, thereby ending the patient’s pain, would be in the patient's best interests. They would argue that letting the disease take its natural cause would be prolonging suffering.