Beneficence

Moral Principle: Beneficence Reference: Tom L Beauchamp and James F Childress, 2013, Principles of Biomedical Ethics

Moral Principle: Beneficence The principle of positive beneficence Protect and defend the rights of others Prevent harm from occurring to others Remove conditions that will cause harm to others Help persons with disabilities Rescue persons in danger

Moral Principle: Beneficence Calculation of benefit Cost-Effectiveness Analysis (CEA) Cost-Benefit Analysis (CBA)

Moral Principle: Beneficence Cost-Effectiveness Analysis (CEA) The benefit in non-monetary term Years of life Quality-adjusted life-year (QALY) Cases of disease Cost per year of live saved Saving years of life Determine which is the most cost-effective

Moral Principle: Beneficence Quality-adjusted life-year (QALY) A measure of health outcome which looks at both length of life and quality of life. QALY are calculated by estimating the years of life remaining for a patient following a particular care pathway and weighting each year with a quality of live score.

Moral Principle: Beneficence Quality-adjusted life-year (QALY) 1 Year of life x 1 Utility = 1 QALY https://www.ncbi.nlm.nih.gov/pmc/articles/PMC317370/

Moral Principle: Beneficence Cost-Benefit Analysis (CBA) Measures both the benefits and the costs in monetary terms Offers a bottom line of a benefit-cost ratio stated in monetary figures that express the common measurement. Different quantitative units (number of accidents, statistical deaths, number of persons treated, etc.)

Moral Principle: Beneficence Cost-Benefit Analysis (CBA) Comparison of program that save lives with that reduce disability or accomplish other goals such as public education

Risk Assessment Risk Management Handbook, Adelaide.edu.au

Risk Assessment Major Minor High 1 2 Low 3 4 Magnitude of Harm Probability of Harm High 1 2 Low 3 4

Moral Principle: Beneficence Risk-benefit analyses Risk perception

Moral Principle: Beneficence Problems of Medical Paternalism Soft and Hard Paternalism Paternalistic policies Paternalism justified by consent Paternalism justified by prospective benefit Justified hard paternalism

Discussion!