Nonmaleficence is the third TJ/BC fundamental bioethical principle I shall evaluate from a libertarian rational natural-rights ethic viewpoint.
Nonmaleficence is commonly defined as the obligation to refrain from causing harm to patients. Thus, nonmaleficence is the duty of a medical professional to not recommend ineffective treatments to patients or act with malice toward patients. Yet, many effective treatments recommended by physicians without malicious intent can cause severe harm to patients (the principle of double effect). The gold standard for nonmaleficence in the physician/patient interaction is informed consent, whereby the physician details the risks and benefits of a treatment to the patient, who then chooses whether or not to proceed with the treatment based on his or her subjective weighting of the risks and benefits. The plumbline libertarian has no objections to this definition of nonmaleficence.
However, many bioethicists, after defining nonmaleficence appropriately, then proceed to assert that, based on the utilitarian theory of ethics that serves as the foundation of public health, a treatment (also known as an intervention) can be prohibited or required by state medical professionals if the intervention - based on the subjective weighting of the risks and benefits by the state medical professionals rather than individual patients - will result in more harm than good (treatment prohibition) or more good than harm (mandatory treatment) on a population basis. The plumbline libertarian opposes this tyrannical exception to the principle of non-maleficence (which also violates the fundamental bioethical principle of respect for autonomy).
Proponents of the public health qualification typically provide several scenarios they claim justify "reasonable" exceptions to the informed consent gold standard for the bioethical principle of non-maleficence. I shall evaluate those farcical scenarios in a future blog post.
Nonmaleficence is commonly defined as the obligation to refrain from causing harm to patients. Thus, nonmaleficence is the duty of a medical professional to not recommend ineffective treatments to patients or act with malice toward patients. Yet, many effective treatments recommended by physicians without malicious intent can cause severe harm to patients (the principle of double effect). The gold standard for nonmaleficence in the physician/patient interaction is informed consent, whereby the physician details the risks and benefits of a treatment to the patient, who then chooses whether or not to proceed with the treatment based on his or her subjective weighting of the risks and benefits. The plumbline libertarian has no objections to this definition of nonmaleficence.
However, many bioethicists, after defining nonmaleficence appropriately, then proceed to assert that, based on the utilitarian theory of ethics that serves as the foundation of public health, a treatment (also known as an intervention) can be prohibited or required by state medical professionals if the intervention - based on the subjective weighting of the risks and benefits by the state medical professionals rather than individual patients - will result in more harm than good (treatment prohibition) or more good than harm (mandatory treatment) on a population basis. The plumbline libertarian opposes this tyrannical exception to the principle of non-maleficence (which also violates the fundamental bioethical principle of respect for autonomy).
Proponents of the public health qualification typically provide several scenarios they claim justify "reasonable" exceptions to the informed consent gold standard for the bioethical principle of non-maleficence. I shall evaluate those farcical scenarios in a future blog post.
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