Beneficence in Medicine

Beneficence in Medicine

I. In my judgment, the physician and care team should give general anesthesia to Ms. R. and perform the Pap smear.

II. The ethical principle that best supports my position is beneficence.

III. Beneficence can be defined as acts of mercy and charity, but can be expanded to include any act that benefits another (Edge & Groves, 1999). The three statements of beneficence as stated by Edge & Groves (1999) are:

1. One ought to prevent evil or harm.

2. One ought to remove evil or harm.

3. One ought to do or promote good.

Nonmaleficence is the ethical principle of doing no harm (Edge & Groves, 1999). Health care professionals have a moral obligation to provide patients with net medical benefits with minimal harm, or beneficence with nonmaleficence. That which is considered a benefit to one patient may be considered harm to another. Each patient must be considered on an individual basis when determining what will benefit them the most. The patient's personal needs and values must be considered. Anytime we try to help others, we risk harming them. Much of what health care professionals do has unintended side effects. The good intentions need to equal or outweigh the harmful effects (Edge & Groves, 1999).

IV. In the case of Ms. R., the risks and benefits must be weighed. Routine gynecologic care is an important aspect of health care for all women. Mentally handicapped women have special needs when it comes to gynecologic care. Ms. R. has limited verbal skills, which makes her unable to express concerns about symptoms. Ms. R. was resistant and uncooperative when gynecologic care was attempted on her. Previous difficult pelvic exams or limited ability to understand what was going on may have been the cause. She felt threatened by the experience for some reason. Ms. R. may also have physical disabilities that would limit mobility, which could make the exam even more difficult.

Pap smears and pelvic exams test for cervical and ovarian cancer. Women who have never had sexual partners are at very low risk for cervical cancer. Most cases of cervical cancer are caused by infection of HPV or human papilloma virus, a sexually transmitted disease. Ms. R. is not sexually active, so she is at lower risk for cervical cancer. But all women are at some risk, and the only way to detect it is with a pelvic exam including a Pap smear. Even though her chances are very small, she still needs to be tested. All women over the age of 18 need to have regular Pap smear tests. Most women need to have the test done every year. Because Ms. R. has had normal tests in the past and is not sexually active, she is able to have one every three years. It has been three years since her last exam, so she needs to

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