Nonmaleficence and Beneficence
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Philosophy
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Dec 6, 2023
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Nonmaleficence and Beneficence
Ashley's treatment creates ethical questions. The idea of "harming versus wronging" suggests
that even when there is no evil intent behind a person's conduct, they may not always consider as
wrong. The remedies in Ashley's instance attempted to simplify her care for her parents and avert
any health problems. However, they also diminished her capacity to give birth and caused
significant, long-lasting bodily alterations. Ashley's therapies could be viewed as optional in
terms of obligatory versus optional treatment because they did not address a life-threatening
disease (Thompson et al., 2020). Ashley's treatments also make us wonder what a "happy life" is
like for those with substantial developmental difficulties when considering quality-of-life issues
for kids with significant diseases or disabilities (Beauchamp & Childress, 2019). However, it
begs the question of who has the power to decide what happens to people's bodies and futures
when they cannot make those decisions for themselves. Ashley's parents and the Ethics
Committee took the decision to pursue these treatments (Gunter, D. F., & Diekema, D. S. 2006).
The prima facie rules of obligation and the theory of beneficence may not align with the
proposed medical treatments for Ashley. The prima facie rules of obligation, such as the duty to
do no harm, respect autonomy, help the person with disabilities, promote beneficence, and rescue
a person in danger, require balancing conflicting moral considerations in a given situation
(Varkey, 2021). Ashley relies on her parents for all areas of her care, including the physical
difficulties she faces while lifting, turning, bathing, preventing skin deterioration, exercising to
maintain joint mobility, etc. Ashley's size and weight reduction not only ease the burden on the
caretakers and enables the finest care for this child but also lessen the demands on Ashley. In
Ashley's case, the treatments aimed to improve her quality of life and care. Still, they also
involved permanent and significant changes to her body and reduced her ability to ability to
develop naturally (Williams, 2017). The theory of beneficence, which holds that individuals have
a natural right to develop to their full potential, may be against the proposed treatments to reduce
Ashley's growth and reproductive capabilities. Ultimately, the decision to pursue Ashley's
treatments raises complex ethical questions about the balance between beneficence and Prima
Facie obligation in caring for individuals with profound developmental disabilities. The final
decision must prioritize Ashley's well-being while respecting her rights and dignity.
Can advanced practice registered nursing services providers decline medical interventions based
on moral conviction? What are the acceptable mitigating techniques when dealing with moral
and ethical dilemmas in non-verbal, incompetent, and impaired children?
References
Beauchamp, T. L., & Childress, J. F. (2019).
Principles of biomedical ethics
(8th ed.). Oxford
University Press.
Buturovic, Z. (2022). Voluntary sterilisation of young childless women: Not so fast.
Journal of Medical Ethics
,
48
(1), 46-49. DOI:
10.1136/medethics-2019-105933
Gunter, D. F., & Diekema, D. S. (2006). Attenuating growth in children with a profound
developmental disability.
The Archives of Pediatrics & Adolescent Medicine, 160
(10), 1013-
1017. https://doi.org/10.1001/archpedi.160.10.1013
Thompson, S., Cannon, M., & Wickenden, M. (2020). Exploring Critical Issues in the Ethical
Involvement of Children with Disabilities in Evidence Generation and Use.
UNICEF Office of
Research – Innocenti Working Paper.
https://www.unicef-irc.org/publications/pdf/IWP-Working-
Paper-ethical-involvement-of-children-with-disabilities-in-evidence-generation.pdf
Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice.
Medical
Principles and Practice, 30
(1), 17-28.
https://doi.org/10.1159/000509119
Williams N. J. (2017). Harms to “Others” and the Selection Against Disability View,
The
Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine
,
42
(2),
154–183.
https://doi.org/10.1093/jmp/jhw067
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