Principle of Nonmaleficence in Nursing: Definition & Examples

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Lesson Transcript
Instructor: Aileen Staller
The word 'maleficent' conjures up images of an evil, ruthless character who does anything regardless of the harm. This lesson examines nonmaleficence and the associated principles of beneficence and justice as they relate to nursing and medical care.

What Is Maleficence/Beneficence?

Nonmaleficence is an ethical principle that obliges one to not inflict intentional harm.

Nonmaleficence requires four things:

  1. An act is not intrinsically wrong
  2. A good effect is intended
  3. The good effect isn't a by-product of a bad effect
  4. The good outweighs the bad

In some instances, it's unclear if harm is intentional or the unfortunate by-product of an act meant to provide benefit. For this reason, the ethical principle of beneficence is considered since this is the act of doing good or performing actions meant to benefit another. Other ethical principles, such as autonomy and justice, may also come into play and need to be considered in certain circumstances. Autonomy is the right of a person to have control over decisions regarding their care, and justice requires that the actions involved must be equitable and fairly carried out.

Examples of Maleficence/Beneficence

Let's look at a couple of examples. First, let's image an elderly man with terminal cancer does not want resuscitation and notifies his physician of that choice. He has a cardiac arrest and the physician wants to place a breathing tube and attach him to a ventilator. His cancer is incurable, his pain is severe, and he will be unable to speak or request medication if resuscitated. The doctor's actions will only prolong his dying. The physician is guilty of maleficence, since the actions provide no benefit or good effect but do inflict intentional harm.

Now, let's look at a group concerned about nutrition that arranges a shipment of powdered milk to be sent to poor villages in Africa. After reconstituting the milk, the villagers find that it produces very bad GI effects (voluminous intestinal gas), since most villagers are lactose intolerant. However, by decreasing the amount of water, they have a thicker product which is excellent for painting their huts and deflecting the heat of the sun. No harm was intended by the group providing the powdered milk. However, another good effect took place and no serious harm came to the villagers; hence this was a nonmaleficent action.

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