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Kindness

398. Kindness (See also Generosity.)

  1. Allworthy, Squire Tom Joness goodhearted foster father. [Br. Lit.: Tom Jones ]
  2. Androcles relieves lion of thorn in paw and is repaid in arena by lions failure to attack him. [Rom. Lit.: Noctes Atticae, Leach, 55]
  3. Bachelor, the the universal mediator, comforter, and friend. [Br. Lit.: Old Curiosity Shop ]
  4. Bishop of Digne gave starving Valjean food, bed, and comfort. [Fr. Lit.: Les Misérables ]
  5. Boaz took benevolent custody of Ruth. [O.T.: Ruth 2:816]
  6. Brownlow, Mr. rescued Oliver Twist from arrest and adopted him. [Br. Lit.: Dickens Oliver Twist ]
  7. calycanthus symbol of compassion. [Plant Symbolism: Jobes, 279]
  8. Carey, Louisa Philips loving, sensitive aunt. [Br. Lit.: Of Human Bondage, Magill I, 670672]
  9. Cuttle, Captain kindly shelters runaway, Florence Dombey. [Br. Lit.: Dombey and Son ]
  10. Evilmerodach Babylonian king; kind to captive king, Jehoiachin. [O.T.: II Kings 25:2729]
  11. Finn, Huckleberry refuses to turn in Jim, the fugitive slave. [Am. Lit.: Huckleberry Finn ]
  12. Francis of Assisi, St. (11821226) patron saint and benevolent protector of animals. [Christian Hagiog.: Hall, 132]
  13. Fridays child loving and giving. [Nurs. Rhyme: Opie, 309]
  14. Glinda the Good Witch; Dorothys guardian angel. [Am. Lit.: The Wonderful Wizard of Oz ; Am. Cinema: Halliwell, 780]
  15. Good Samaritan helps out man victimized by thieves and neglected by other passers-by. [N.T.: Luke 10:3035]
  16. heart symbol of kindness and benevolence. [Heraldry: Halberts, 30]
  17. Hood, Robin helps the poor by plundering the rich. [Br. Lit.: Robin Hood ]
  18. Jesus Christ kind to the poor, forgiving to the sinful. [N.T.: Matthew, Mark, Luke, John]
  19. Joseph of Arimathaea retrieved Christs body, enshrouded and buried it. [N.T.: Matthew 27:5761; John 19:3842]
  20. Kuan Yin goddess of mercy. [Buddhism: Binder, 42]
  21. La Creevy, Miss spinster painter of miniatures who devoted herself to befriending the Nicklebys. [Br. Lit.: Dickens Nicholas Nickleby ]
  22. lemon balm symbol of compassion. [Herb Symbolism: Flora Symbolica, 164]
  23. Merrick, Robert doing good to others as raison dêtre. [Am. Lit.: The Magnificent Obsession, Magill I, 547549]
  24. Nereus venerable sea god of great kindliness. [Gk. Myth.: Century Classical, 744745]
  25. Old Woman of Leeds spent all her time in good deeds. [Nurs. Rhyme: Mother Goose, 97]
  26. ox exhibits fellow-feeling for comrades. [Medieval Animal Symbolism: White, 7778]
  27. Peggotty, Daniel kindhearted bachelor who shelters niece and nephew. [Br. Lit.: David Copperfield ]
  28. Philadelphia city of brotherly love. [Am. Hist.: Hart, 651]
  29. Rivers, St. John takes starving Jane Eyre into his home. [Br. Lit.: Jane Eyre ]
  30. Rodolph, Grand Duke helps criminals and the poor to a better life. [Fr. Lit.: Sue The Mysteries of Paris in Magill I, 632]
  31. Romola cares lovingly for her blind father, provides for her husbands mistress and children, and is kind to all who suffer. [Br. Lit.: George Eliot Romola ]
  32. St. Martin in midwinter, gave his cloak to a freezing beggar. [Christian Hagiog.: Brewer Dictionary ]
  33. Strong, Doctor the kindest of men. [Br. Lit.: David Copperfield ]
  34. throatwort indicates sympathy. [Flower Symbolism: Flora Symbolica, 178]
  35. Veronica, St. from pity, offers Christ cloth to wipe face. [Christian Hagiog.: Attwater, 334]
  36. Vincent de Paul, St. French priest renowned for his charitable work. [Christian Hagiog.: NCE, 2896]
  37. Wenceslas, St. Bohemian prince noted for piety and generosity. [Eur. Hist.: Brewer Dictionary, 1147]

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Beneficence

BENEFICENCE

In public health, the governing ethical theory is utilitarianism, meaning "doing the greatest good for the largest number of people." Beneficence is strongly tied to the utilitarian theory of ethics. It is one of four principles considered in medicine and public health under the principle-based approach to ethical analysis. The other three principles are: respect for autonomy, nonmaleficence, and distributive justice. Beneficence is the professional duty to do or produce good. By "good" is meant the performance of acts of kindness and charity. "Doing good" is considered virtuous conduct. Ultimately, beneficence is the duty to do more good than harm through public health actions because, in practice, no action in public health will have exclusively beneficial effects. For example, if a public health agency becomes aware of a person infected with a bacterium that could be spread through the air, then, there is, on the one hand, a duty to respect the person's right to confidentiality and freedom of movement. But, on the other hand, there is a greater duty to prevent the spread of the bacterium to other people. Thus, more good would be achieved by protecting the public health, which can be accomplished only by breaching the duty to maintain the infected person's confidentiality and freedom of movement. Such breaches would occur only to reduce the risk associated with permitting the infectious person to put others at risk of infection (e.g., through quarantine or confinement, with a consequent loss of privacy in terms of the diagnosis). The ethical dilemma for decision makers in public health lies in weighing the pros and cons between at least two conflicting options: protecting the individual's rights or protecting the public health. Such breaches of an individual's rights are rare in public health and are undertaken only with maximum discretion.

Colin L. Soskolne

(see also: Autonomy; Ethics of Public Health; Nonmaleficence; Paternalism )

Bibliography

Beauchamp T. L., and Childress, J. F. (1994). Principles of Biomedical Ethics, 4th edition. New York: Oxford University Press.

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beneficence

beneficence (bi-nef-i-sĕns) n. (in health care) the duty to do good and avoid doing harm to other people, which includes acting to promote their interests and protecting the weak and vulnerable. It includes the duty of advocacy (see advocate).

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kindness

kind·ness / ˈkīn(d)nis/ • n. the quality of being friendly, generous, and considerate. ∎  a kind act: it is a kindness I shall never forget.

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beneficence

beneficenceabeyance, conveyance, purveyance •creance • ambience •irradiance, radiance •expedience, obedience •audience •dalliance, mésalliance •salience •consilience, resilience •emollience • ebullience •convenience, lenience, provenience •impercipience, incipience, percipience •variance • experience •luxuriance, prurience •nescience • omniscience •insouciance • deviance •subservience • transience •alliance, appliance, compliance, defiance, misalliance, neuroscience, reliance, science •allowance •annoyance, clairvoyance, flamboyance •fluence, pursuance •perpetuance • affluence • effluence •mellifluence • confluence •congruence • issuance • continuance •disturbance •attendance, dependence, interdependence, resplendence, superintendence, tendance, transcendence •cadence •antecedence, credence, impedance •riddance • diffidence • confidence •accidence • precedence • dissidence •coincidence, incidence •evidence •improvidence, providence •residence •abidance, guidance, misguidance, subsidence •correspondence, despondence •accordance, concordance, discordance •avoidance, voidance •imprudence, jurisprudence, prudence •impudence • abundance • elegance •arrogance • extravagance •allegiance • indigence •counter-intelligence, intelligence •negligence • diligence • intransigence •exigence •divulgence, effulgence, indulgence, refulgence •convergence, divergence, emergence, insurgence, resurgence, submergence •significance •balance, counterbalance, imbalance, outbalance, valance •parlance • repellence • semblance •bivalence, covalence, surveillance, valence •sibilance • jubilance • vigilance •pestilence • silence • condolence •virulence • ambulance • crapulence •flatulence • feculence • petulance •opulence • fraudulence • corpulence •succulence, truculence •turbulence • violence • redolence •indolence • somnolence • excellence •insolence • nonchalance •benevolence, malevolence •ambivalence, equivalence •Clemence • vehemence •conformance, outperformance, performance •adamance • penance • ordinance •eminence • imminence •dominance, prominence •abstinence • maintenance •continence • countenance •sustenance •appurtenance, impertinence, pertinence •provenance • ordnance • repugnance •ordonnance • immanence •impermanence, permanence •assonance • dissonance • consonance •governance • resonance • threepence •halfpence • sixpence •comeuppance, tuppence, twopence •clarence, transparence •aberrance, deterrence, inherence, Terence •remembrance • entrance •Behrens, forbearance •fragrance • hindrance • recalcitrance •abhorrence, Florence, Lawrence, Lorentz •monstrance •concurrence, co-occurrence, occurrence, recurrence •encumbrance •adherence, appearance, clearance, coherence, interference, perseverance •assurance, durance, endurance, insurance •exuberance, protuberance •preponderance • transference •deference, preference, reference •difference • inference • conference •sufferance • circumference •belligerence • tolerance • ignorance •temperance • utterance • furtherance •irreverence, reverence, severance •deliverance • renascence • absence •acquiescence, adolescence, arborescence, coalescence, convalescence, deliquescence, effervescence, essence, evanescence, excrescence, florescence, fluorescence, incandescence, iridescence, juvenescence, luminescence, obsolescence, opalescence, phosphorescence, pubescence, putrescence, quiescence, quintessence, tumescence •obeisance, Renaissance •puissance •impuissance, reminiscence •beneficence, maleficence •magnificence, munificence •reconnaissance • concupiscence •reticence •licence, license •nonsense •nuisance, translucence •innocence • conversance • sentience •impatience, patience •conscience •repentance, sentence •acceptance • acquaintance •acquittance, admittance, intermittence, pittance, quittance, remittance •assistance, coexistence, consistence, distance, existence, insistence, outdistance, persistence, resistance, subsistence •instance • exorbitance •concomitance •impenitence, penitence •appetence •competence, omnicompetence •inheritance • capacitance • hesitance •Constance • importance • potence •conductance, inductance, reluctance •substance • circumstance •omnipotence • impotence •inadvertence • grievance •irrelevance, relevance •connivance, contrivance •observance • sequence • consequence •subsequence • eloquence •grandiloquence, magniloquence •brilliance • poignance •omnipresence, pleasance, presence •complaisance • malfeasance •incognizance, recognizance •usance • recusance

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Beneficence

BENEFICENCE

•••

Beneficence denotes the practice of good deeds. In contemporary ethics, the principle of beneficence usually signifies an obligation to benefit others or to seek their good. It is a principle of major importance in bioethics and has been prominent in the codes of physicians since antiquity.

Beneficence and Benevolence

Beneficence as a principle that guides decisions should be distinguished from the virtue that motivates actors. TheOxford English Dictionary defines "beneficence" as "doing good, the manifestation of benevolence, or kindly feeling" (emphasis added). This definition bespeaks the etymology of both terms. Beneficence is derived from the Latin bene (well; from bonus, good) and facere (to do), whereas benevolence is rooted in bene and volens (a strong wish or intention) (Partridge). Philosophers who emphasize a more rationalist approach, calculated to guide principled choices, tend to endorse beneficence. Those who see ethics as primarily concerned with virtue, character, and the psychological dimensions of the moral life emphasize benevolence.

David Hume, for example, conceived of benevolence as one of the instincts originally implanted in human nature. Like Joseph Butler, Francis Hutcheson, Adam Smith, and other eighteenth-century English-speaking philosophers, Hume was not so much concerned with ethical problem solving as with describing the role and place of benevolence in the moral topography of human beings. Adam Smith used the term beneficence, but employed it to describe the virtue of goodwill, and saw it as a moral passion rather than a principle. Of concern to all these philosophers was a task set for them by Thomas Hobbes a century earlier.

Hobbes set the modern polemical context for discussions not only of beneficence and benevolence but also of ethics more generally. His moral philosophy was determinist, denying any capacity for choice based on values, and relativist, denying any independent reference for the terms good and evil: Liberty he saw as merely the ability to enact one's desires, not freedom to deliberate and choose. Good and evil simply denoted human appetites and aversions. "Will" was just another desire, not a distinctive moral capacity. Obviously such a philosophy was no place for beneficence as a principle of choice or benevolence as a motivation for the good of others. Ethics devolves into a deterministic egoism. Butler, Hutcheson, Hume, and Smith, in a variety of ways, took as their task a survey of the moral psyche, with special regard for the place of benevolence as something innate or natural to human life.

Unless Hobbes's egoistic portrait is correct, any well-rounded view of ethics will include ways of describing and evaluating both the motivational and character-laden aspects, and the decisional, action-oriented elements of ethics— that is, both benevolence and beneficence.

A principle of beneficence can be broadly or narrowly defined. William Frankena views beneficence as an inclusive principle involving elements of refraining from inflicting harm and preventing or removing evil, as well as an obligation actively to promote good. James Childress adopts Frankena's elements but reclassifies them according to two distinct principles: nonmaleficence, the obligation not to inflict harm; and beneficence, the obligations to prevent harm, to remove harm or evil, and positively to promote good. This refinement has the merit of following an intuitive division between refraining and active doing. It elucidates why refraining from harm is usually seen as a universal duty to others, while actively promoting good or helping others is typically seen as a less stringent obligation and often as resulting from specific role obligations (being a parent or a doctor) or contractual agreements. A broader-ranging sense of beneficence is, nevertheless, endorsed by some philosophers. For example, in The Right and the Good, W. D. Ross claimed that duties of beneficence are incurred because of "the mere fact that there are other human beings in the world whose condition we can make better …" (p. 21).

Relation to Utility

Beneficence has natural affinities with a principle of utility. Tom Beauchamp and James Childress, for example, claim that promoting good always involves a calculation of what harms might also be incurred. A principle of utility is a way to assess harms and benefits. In his Utilitarianism, John Stuart Mill asserted in 1863 that the measure of "good" by which all actions are to be judged is whether they promote the greatest happiness for the greatest number. Mill saw his principle of utility as a systematic expression of the teaching of Jesus, for example, as embodied in the "golden rule."

When defined through Mill's utility principle, beneficence becomes vulnerable to two criticisms frequently leveled at utilitarianism. The first is the problem of adequacy. A focus on beneficence as the promotion of happiness, to the exclusion of other kinds of goods and obligations, seems too narrow. People value things other than happiness, however broadly defined. Promoting the happiness of others can conflict with treating them fairly or respecting them as persons. The second problem is idealism. For Mill at least, utilitarianism presented a stringent requirement. "As between his own happiness and that of others utilitarianism requires him to be as strictly impartial as a disinterested and benevolent spectator" (1979, p. 16). To count the good of strangers equally with our own good, or that of our families or friends, seems saintly and perhaps impossible to achieve.

These problems have led some philosophers to question utilitarianism as a system but also to see beneficence as only one principle among others, and as usually (if not always) an imperfect or supererogatory duty. While some principle of utility is necessary to enact beneficence, it need not be Mill's rendition. A utility principle that recognized a variety of goods would at least moderate the force of the criticisms above.

Beneficence and Autonomy

How beneficence is put into practice depends on how it is modified by other principles. Especially important in this regard is respect for autonomy or self-determination. Another way to put this is to ask whose notion of good will be definitive. Respect for autonomy means that good will be defined by the recipient of the action rather than the agent. Beneficence not so defined leads to paternalism, in which the beneficent actor overrides or ignores the recipient's ideas of good and imposes his or her own. The history of medical ethics is largely (but not entirely) a history of paternalistic beneficence. In the mid-twentieth century, consistent challenges arose to beneficent paternalism through assertions of patient rights. Defenders of simple paternalism in healthcare relationships are now rare, and most ethicists would agree with Erich Loewy that paternalistic actions generally represent a "caricature" rather than a natural extension of beneficence.

Autonomy as a moral principle is historically rooted in freedom as a political principle, to which John Locke's Second Treatise of Government (1690) gave definitive expression. Freedom, Locke asserted, is not license "but a liberty to dispose, and order as he lists, his person, actions, possessions, and his whole property, within the allowance of those laws under which he is, and therein not to be subject to the arbitrary rule of another, but freely follow his own" (p. 32). The eighteenth-century monument to autonomy is the work of the German philosopher Immanuel Kant. Whereas Locke was concerned to protect individuals from the power of the state, Kant focused on freedom of the will. His "practical imperative" requires that others be treated as ends in themselves and never only as a means. For Kant this respect for the moral freedom of others was grounded in a recognition of their rational nature. In bioethics this raises the difficult issue of when and to what extent the rational capacities of patients are compromised and in which cases autonomy should give way to medical beneficence.

The grounds for limiting beneficence through respect for autonomy were most powerfully stated by John Stuart Mill. In On Liberty (first published in 1859) he cautioned against supposing that the principle of liberty necessitates a "selfish indifference." Indeed, he asserted, "there is need of a great increase of disinterested exertion to promote the good of others." But, he continued, "disinterested benevolence can find other instruments to persuade people to their good than whips and scourges, either of the literal or of the metaphorical sort" (p. 74).

While advocacy for autonomy as the preeminent principle of medical ethics was powerful during the 1970s and 1980s, there are still substantial voices for a beneficencebased theory. Edmund Pellegrino and David Thomasma argue that "medicine as a human activity is of necessity a form of beneficence" (p. 32). Rather than espousing the older traditions of paternalism, however, they argue for an enlarged beneficence, "beneficence-in-trust"—a non-rightsbased approach that includes respect for autonomy but emphasizes a fiduciary grounding for doctor–patient encounters. This approach has an advantage over singleprinciple approaches that ground medical obligations in simple beneficence or simple autonomy, conceived as monolithic norms. Beneficence, unleavened by respect for autonomy, can lead to paternalism, while autonomy alone obviates trust and often deteriorates into indifference. Still the feasibility of trust depends upon shared values and goals, or at least stable role expectations between providers and patients. The greater the pluralism in a society, the less likely it is that the trust Pellegrino and Thomasma commend can be established.

Health Professional Codes

While beneficence is important to many philosophical and religious systems of ethics, it is central to the health professions. The Hippocratic Oath clearly states that the physician's actions are "for the benefit of the sick" (see Appendix for this and other codes and oaths). The Declaration of Geneva begins with a pledge to "consecrate" one's life to "the service of humanity." The 1980 "Principles" of the American Medical Association (AMA) opens with the declaration that these principles are established "primarily for the benefit of the patient." The International Code for Nurses devised in 1973 begins with a broad-ranging assertion of beneficence. The "fundamental" responsibility of the nurse, it states, is to promote and restore health, alleviate suffering, and prevent illness. While duties to specific persons are recognized, the obligation to perform beneficent actions is seen as universal, because the need for nursing services is universal.

The U.S. Code for Nurses of 1976 differs from all physician codes in recognizing that services not only should promote good but also should be guided by the values of those served. The first principle in this formulation asserts the "self-determination of clients." As noted above, self-determination, or autonomy, is frequently seen as a limiting factor in gauging the extent of beneficence, yet this factor is rarely mentioned in the ethical formulations of health professionals. For example, the practice of soliciting consent from patients was evident in medical practices in the United States in the eighteenth century. Yet these solicitations were not commensurate with today's notion of informed consent. Consent was sought in the eighteenth century primarily to enhance therapy rather than to encourage independent decision making by patients (Faden et al.). Jay Katz presses this point by asserting that consent is largely "alien" to medical thinking, which prefers "custody" over "liberty."

Still, claims for the modern uniqueness of informed consent should be viewed with caution, especially when they tend to valorize an "autonomy model" over a "beneficence model" (Faden et al.). It would be anachronistic to believe that eighteenth-century physicians worked with the mid-twentieth-century concept of consent. Yet it is too sweeping and dualistic to believe that, by default, they were under the sway of a "beneficence model." Medical practices, or moral practices more generally, do not lend themselves to easy encapsulation into models, just as beneficence as a practice is not identical with the philosophical principle of beneficence.

While all versions of professional ethics agree that the acceptance of a patient or a client creates a specific obligation of beneficence, some codes go further and talk of a general duty to seek the public good in matters of health. Here the 1847 Code of the American Medical Association is notable. Chapter III of that code enumerates "Duties of the Profession to the Public." Among those listed are vigilance for the welfare of the community, counsel to the public on health matters, and advice about epidemics, contagion, and public hygiene. Twentieth-century medical codes tend to be more parsimonious in their interpretations of what beneficence entails.

Not even the more generous beneficence in the 1847 AMA Code, however, takes it to cover what Charles Fried calls "the duty to work for and comply with just institutions"(p. 129). Fried here follows and extends the thinking of Kant, who saw beneficence in terms of a duty of mutual aid. Such aid is required because all persons (including ourselves) will at some time need the help of others, so to neglect aiding others would be self-defeating. The societal and public policy implications of beneficence in healthcare are poorly worked out at present. The issues that require attention include general programs of prevention, medical assistance to specific groups (such as AIDS patients), and healthcare for the indigent and uninsured. Most proposals for a more equitable healthcare system in the United States build on notions of justice as an independent principle rather than deriving their justifications from an extension of duties of beneficence.

Limits

If beneficent duties are more than supererogatory, or optional, a persistent issue is how to discern their proper scope. Where do obligations to benefit others end? Are we morally required to give away all our surplus income and, beyond that, to chasten ourselves to more modest patterns of consumption? Are physicians obligated never to say "no" to patients so long as any thread of hope for improvement exists? Would beneficence require acceptance of higher taxes to fund universal health coverage, or does acting for my fellow citizens' good require me to die cheaply and forgo expensive treatments with low probability of benefit?

Beneficent duties may be limited in two ways. The first limiting force is duties to oneself. Self-respect, and an appropriate attention to one's own well-being, will of necessity restrict activities for the good of others, unless beneficence is given a preemptive place and is conflated with saintliness. Hume, for example, believed persons can be "too good, " carrying "attention for others beyond the proper bounds, " blunting a due sense of pride and the self-assertive virtues (p. 93). A second kind of limit involves our psychological capacity for identification of and sympathy with those who could use our help. The press of human suffering that could be alleviated by our actions is immense. To conceive of this larger and seemingly inexhaustible world of suffering as our charge would likely be debilitating. Jonathan Glover has suggested that a restricted but feasible beneficence may be the price we pay for our sanity. Limits to the duty to promote good restrict us, but also orient and direct our finite capacities. But perhaps the greater risk is that we will draw a circle around duties in a niggardly fashion, that our imagination will not be too large, risking paralysis, but too stingy and self-serving. It is this narrow and parochial tendency that concerns the advocates of a robust and extensive beneficence.

Relational Selves

The recent challenges to ethical theory from psychological studies of moral experience have profound implications for beneficence. In 1982 Carol Gilligan published her research on the moral development of women, titled In a Different Voice. She claimed that females tend to see moral problems in terms of relationships. They are prone to think of their choices in problem solving as issues of care and responsibility for those relationships. By contrast, males tend to see moral problems in terms of rules and principles, and are prone to think of their choices as logical adjudications. Women's moral orientations tend toward valuing and preserving ties among persons, while men's tend toward abstract thinking by an agent largely removed from and impartial to the parties involved. Gilligan's claim is not that there are precise gender types for moral experience but that the model of the moral self as an abstract, isolated, principled, and hierarchical thinker is insufficient.

Consider the case of Jake and Amy, two eleven-yearolds, who discuss the question "When responsibility to oneself and responsibility to others conflict, how should one choose?" (Gilligan, pp. 35ff.). While Jake adjudicates these responsibilities as if it were a problem of rule application, Amy's response is pragmatic and assumes a relational self. Jake seeks fairness in the manner of a judge; Amy is concerned to see that others' needs are met and relationships are nurtured. The point is not so much that Jake and Amy offer different answers but that they see different issues, and see themselves in different ways.

The implications for a principle of beneficence in bioethics, and in the ethical codes of health professionals, are substantial. Gilligan's research directly challenges the adequacy of thinking of beneficence simply as a principle to be applied to cases, and recommends a notion of beneficence grounded in complex, relational understandings of the self. Hence, the issues of beneficence can no longer be formulated as if the agent were essentially solitary and could contemplate the scope of his or her duties from afar. The self is already, and essentially, immersed in a web of convivial responsibilities. The ethical formulations of most health professions exhibit precisely the hierarchical distancing and the assumption of optional relationships depicted in the "male" model. Attending to the second voice in moral experience would mean moving bioethics beyond an exhaustive reliance on applying beneficence, as a principle, to problem cases. It would also mean taking the ethical codes of health professionals beyond the contract model and into a recognition of a deeper and more integral bond between healers and the sick, and between health professionals and society.

larry r. churchill (1995)

SEE ALSO: Autonomy; Bioethics; Compassionate Love; Confidentiality; Ethics: Normative Ethical Theories; Justice; Paternalism; Professional-Patient Relationship

BIBLIOGRAPHY

Beauchamp, Tom, and Childress, James. 1989. Principles of Biomedical Ethics. 3rd edition. New York: Oxford University Press.

Beauchamp, Tom, and McCullough, Lawrence. 1984. Medical Ethics: The Moral Responsibilities of Physicians. Englewood Cliffs, NJ: Prentice-Hall.

Childress, James F. 1982. Who Should Decide?: Paternalism in Health Care. New York: Oxford University Press.

Faden, Ruth, and Beauchamp, Tom, with Nancy King. 1986. A History and Theory of Informed Consent. New York: Oxford University Press.

Frankena, William. 1973. Ethics. 2nd edition. Englewood Cliffs, NJ: Prentice-Hall.

Fried, Charles. 1978. Right and Wrong. Cambridge, MA: Harvard University Press.

Gilligan, Carol. 1982. In a Different Voice: Psychological Theory and Women's Development. Cambridge, MA: Harvard University Press.

Glover, Jonathan. 1977. Causing Death and Saving Lives. London: Penguin.

Hobbes, Thomas. 1947. Leviathan, ed. Michael Oakeshott. New York: Oxford University Press.

Hume, David. 1966 (1777). An Enquiry Concerning the Principles of Morals. 2nd edition. La Salle, IL: Open Court.

Kant, Immanuel. 1959. Foundations of the Metaphysics of Morals, tr. Lewis White Beck. New York: Macmillan.

Katz, Jay. 1984. The Silent World of Doctor and Patient. New York: Free Press.

Locke, John. 1980 (1690). Second Treatise of Government, ed. Crawford B. MacPherson. Indianapolis: Hackett.

Loewy, Erich. 1991. Suffering and the Beneficent Community: Beyond Libertarianism. Albany: State University of New York Press.

Mill, John Stuart. 1978 (1859). On Liberty. Indianapolis: Hackett.

Mill, John Stuart. 1979 (1863). Utilitarianism. Indianapolis: Hackett.

Partridge, Eric. 1983. Origins: A Short Etymological Dictionary of Modern English. New York: Greenwich House.

Pellegrino, Edmund D., and Thomasma, David C. 1988. For the Patient's Good: The Restoration of Beneficence in Health Care. New York: Oxford University Press.

Ross, W. D. 1930. The Right and the Good. Oxford: Clarendon Press.

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