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The Stanford Prison Experiment...

Das Experiment (2001)

The Experiment (2010)

Benefit and Harm

A M A L IA M U H A I MIN
DE PA RTME NT OF BIOE THI C S, SCHOOL OF ME DICINE
U NIVE RSITA S JE NDE RA L SOE DIRMA N

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BIOETHICS AND HUMANITIES

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Learning Objectives
Students should be able to identify benefits and harms in daily settings and
health care settings

Why do you study?

Students should be able to evaluate harms and benefit in daily settings and
health care settings

Why do you study

medicine?

Students should be able to justify decisions taking harms and benefits into
account

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BIOETHICS AND HUMANITIES

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BIOETHICS AND HUMANITIES

Benefit
What is a health benefit?

Are health benefits only available to unhealthy people??

Why do we see a doctor?

Health

Health benefits are available to people who do not presently suffer from any
disease

Care

Prophylactic treatments or disease prevention programs vaccination

Relief of suffering

Restoring proper physical functioning treating results of non-disease events

such as broken legs and brain injuries

Prevention of disease, illness, disability

the social context of a physical condition

Psychological benefit
Enhancement
etc.

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What is harm?
What is the concept of health?

= bahaya, kerugian, kemalangan, kerusakan

The WHO definition of health:

Examples...

A state of complete physical, mental, and social well-being and not

merely the absence of disease or infirmity

ovarian cyst surgical procedure, delivering cancer diagnosis,

Too narrow or too wide??

physical harm

the WHO definition is often criticized for being too wide; it is encompassing
many situations that are not disease related and that can expand the area of
work of medical doctors

psychological harm

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Interpretations of harm?

moral harm (harm to interests, harm as unfairness, harm as disrespect)

social/economic harm (consequences for social role, stigmatization)
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Primum non nocere

BIOETHICS AND HUMANITIES

In ancient medical ethics, an important moral principle is above all do

no harm continues to be used as an important ethical principle in
contemporary health care.

Surgery, chemotherapy, drugs/medications, etc.

What justifies them is the net balance of benefit over the harm which the
treatments inevitably involve
Any clinical intervention has to be undertaken only after the completion of a
risk of harm/likelihood of benefit calculation

Can a physician avoid harm?

What is the distinction between expected and unexpected harm?

Where the risk of harm outweighs possible benefit, then the treatment is
not indicated

BIOETHICS AND HUMANITIES

Who determines what counts as harm?

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In health care practice it is important to evaluate benefits and

harms!!

Questions:

Difficulties of measuring harms and benefits in individual

patients, may involve:

Can you think of any (previous) technology that you think is too
risky to be used now?

The assessment of degrees of harm and benefit

If you can, think about the current technologies we use in that

area for that goal?

The social context of physical and mental suffering

The subjective nature of suffering

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Will uncertainty ever be eliminated??

above all do no harm

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Looking back, do you think the current technology causes harms

also?

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Reference

CONCLUSION
A fundamental way of reasoning that people have is to balance doing good
against a risk of doing harm

UNESCO. Bioethics Core Curriculum. UNESCO, 2008. Available at:

http://unesdoc.unesco.org/images/0016/001636/163613e.pdf

Assessment has to be made between risk of harms and potential benefits for
different individuals

UNESCO Bangkok. A Cross Cultural Introduction to Bioethics. Eubios Ethics Institute, 2006.
Available at: http://www.eubios.info/ccib.htm
http://www.unescobkk.org/rushsap/resources/shs-resources/ethics-resources/bioethicsdocumentation-centre/bioethics-textbook/

Always ask: who benefits and who is at risk of harm?

Important for resource allocation; when time or material resources are scarce

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