For the Patient's Good: The Restoration of Beneficence in Health Care

Title: For the Patient's Good: The Restoration of Beneficence in Health Care
ABP identifier: ABP-W-0026
Creator: Edmund D. Pellegrino
Date: 1988
Type: Book
Description: Pellegrino and Thomasma responded to the conflict between medical paternalism and an autonomy understood mainly as patient control. They proposed “beneficence-in-trust,” an account in which clinical judgment, the patient’s values, and the moral commitments of the healing relationship jointly define the patient’s good.
Intellectual stream: Clinical ethics & professionalism; Principles & methods
Verification status: Verified
Evidence confidence: High
Historical significance: Pellegrino and Thomasma responded to the conflict between medical paternalism and an autonomy understood mainly as patient control. They proposed “beneficence-in-trust,” an account in which clinical judgment, the patient’s values, and the moral commitments of the healing relationship jointly define the patient’s good. The book applied this framework to surrogate decisions, nutrition and hydration, quality-of-life judgments, gatekeeping, and for-profit medicine. It is significant because it made the philosophy of medicine and virtue-oriented professional ethics a sustained alternative to rule-based analysis. The argument also illustrates a central late-twentieth-century effort to preserve beneficence without returning to unilateral physician authority.