2. Beneficence:
Beneficence is the direction that research ought to offer some benefit of an improved outcome for patients who participate in a research experiment.
Beneficence is the principle that human subjects should also stand to benefit in some way from participating in an experiment. This principle goes beyond the notion of goal or intention; it is instead an obligatory element of the research concept. Surgeons will understandably already be familiar with the generalized rules:
- Do not harm
- Maximize possible benefits and minimize possible harms
The first precept represents the contra positive statement of beneficence, commonly called the principle of nonmaleficence in medical ethics. Literally, it mandates that one ought not to inflict evil or harm.
For surgical researchers, the extension of this idea is that one should not impose risks of harm. In cases of risk imposition, law and morality recognize a standard of due care that determines whether the agent that is causally responsible for the harm is legally or morally responsible as well. This relates to the second maxim, that researchers are obliged to give thoughtful consideration to their experimental design in order to maximize the possible benefits to subjects and simultaneously minimize possible harms.
What constitutes harm in the case of surgical research or innovation can vary. When performing an experimental procedure of unproven worth, a surgeon exposes a patient to unknown risks. These risks can be of great magnitude (the ultimate being death) or of relatively small impact. This practice has been termed by some as "reckless experimentation" and indicating that it should always be condemned regardless of estimated risks. For most experiments, the requirement of beneficence can be met through careful consideration and forethought about the likely and unlikely outcomes of subjects' participation.
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