Nonmaleficence in professional life
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Nonmaleficence in Professional Life. Thomas Donlin-Smith, Professor of Religious Studies. Nonmaleficence in Professional Life. “First, do no harm”. What counts as harm?. Example: paternalism Motivated by benevolence yet experienced as harm.

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Nonmaleficence in Professional Life

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Nonmaleficence in professional life

Nonmaleficencein Professional Life

Thomas Donlin-Smith, Professor of Religious Studies


Nonmaleficence in professional life1

Nonmaleficence in Professional Life

  • “First, do no harm”


What counts as harm

What counts as harm?

  • Example: paternalism

  • Motivated by benevolence yet experienced as harm.

  • Best safeguard against paternalism – client’s voluntary, informed, competent consent

    • Voluntariness. Avoiding “controlling influences.”

    • Information. Levels & comprehension issues.

    • Competence. Can be difficult to ascertain. Means competence for this decision (not in general).


Are some harms justifiable

Are some harms justifiable?

  • E.g., principle of veracity and the possibility of justifiable lies to and for clients.

  • What’s the harm in lies?

    • Much of professional life is based on trust and promises, either explicit or implicit.

      • False promises & broken promises may provide short term gain, but destroy trust.

    • Lies are ways of controlling & manipulating people, getting them to do things they would not otherwise do. Lies infringe on others’ autonomy.

  • The tendency to lie may be strengthened or diminished by the metaphor or model of relationship we are using.


Conditions for justifying lies

Conditions for justifying lies

  • Is this lie a last resort? Exhaust all truthful alternatives.

  • Weigh & assess the moral principles & issues at stake. Who is being protected & who is being hurt & why? Does the good outweigh the bad (utility)?

  • “Publicity test” - what would others say? How does this look from the dupe’s perspective?

  • Does the dupe have a right to the truth? Or is there a special latitude with truth permitted in this professional relationship?

  • Slippery slope concerns.


Another type of harm in the professional client relationship privacy and confidentiality violations

Another type of harm in the professional-client relationship: privacy and confidentiality violations


Two basic rules

Two basic rules

  • Privacy – obligation to minimize invasions of client’s personal information

    • Client’s right to know what info is gathered & why

  • Confidentiality – obligation to protect client information

    • Client’s right to proper safeguards and to know about these safeguards


Privacy confidentiality are important because

Privacy & confidentiality are important because . . .

  • Deontologically:

    • They express basic respect.

    • A promise (at least implied)

  • Consequentially:

    • They maintain trust & encourage the full disclosure pros need in order to do their work

  • Virtue:

    • Don’t be a voyeuristic gossip!


Limits on confidentiality rules

Limits on confidentiality rules?

  • May break confidence only when there is a duty to do so. May only when must.

  • Begin by asking for waiver of confidentiality

  • Better to violate confidence for the sake of preventing harms than to do good

  • Better for the sake of preventing harms to third parties than for the client’s own protection


Considerations in confidentiality violations

Considerations in confidentiality violations

  • Only as a last resort

  • Minimize the amount

  • Give the client a justification

  • Specific, legally required breeches of confidentiality:

    • Suspected child abuse

    • Bullet wounds

    • Selected communicable diseases

    • Threatened injury to third party


Temptations to harm

Temptations to harm

  • What factors lead to professional misconduct, lack of “due care,” in professional practice?

  • How to enforce moral standards to prevent or punish misconduct?

  • See Banks McDowell, “The Excuses That Make Professional Ethics Irrelevant”


Mike martin on professional misconduct

Mike Martin on professional misconduct

  • Usually amounts to the triumph of private goods over public goods.

    • Religious ethics as antidote?

  • Two fundamental dangers in modern pro life:

    • conflict of interests of advising about & providing services

    • “hired gun” mentality that erodes personal responsibility


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