Copyright Goodheart-Willcox Co., Inc 28 Unit 1 Foundations of Medical Law and Ethics If the patient is a child, the parents typically have the authority to make these kinds of healthcare decisions. In such a case, if the parents were refusing the life-saving blood transfusion on religious grounds, the healthcare providers might challenge the parents’ decision. There is legal precedence for overriding the parents’ wishes by appealing to the Juvenile Court Judge who is authorized by the state to protect the lives of its citizens, particularly minors. The court might determine that the child, if making his or her own autonomous decision, would prefer the transfusion to reliance on divine action. The court could override the autonomy of the child’s parents as the surrogate decision makers and act in their place. Chapter 13 includes further discussion of the rights of minors related to healthcare. 2. Beneficence is the principle that directs a medical practitioner to act in the best interest of the patient and provide skilled assistance to others. This concept means that a practitioner should always act to improve the patient’s condition. This often requires practitioners to balance risks and benefits of different treatments, favoring what is in the best interest of the patient. For example, if a 98-year-old woman fell and fractured her hip, a physician would need to consider what is best for her (Figure 2.8). It might be normal to recommend surgery for this injury. However, due to the patient’s advanced age and the possible impact on her cardiovascular system from surgery, another course of treatment, such as a long period of self-healing with rest and pain medication, might be the best option. 3. The concept of non-malfeasance dictates that a medical practitioner must do no harm to a patient. Harm might occur when a practitioner fails to meet professional standards through ineffective, careless, or intentional wrongful acts. The concept of non-malfeasance is linked to beneficence but focuses on the practitioner’s own readiness and personal intent. For example, a healthcare practitioner should not undertake an action without having the minimum skill and knowledge that other practitioners performing a similar treatment under similar conditions would have. If a certain dosage of radiation has been proven to help a cancer patient, tripling the dosage may be considered malfeasance if the practitioner is careless of the probable consequences. ­ Well-intended harmful acts are not proper if they would not be undertaken by others with proper skill and training. beneficence the act of performing goodness, kindness, or charity, including all actions intended to benefit others based on a moral obligation to do so non-malfeasance the principle that requires a practitioner to do no harm to a patient by not performing up to professional standards, such as through ineffective, careless, or intentional wrongful acts