Benefit and Harm

  • Donald Evans
Reference work entry


There is an apparent tension between two major obligations identified in the Universal Declaration on Bioethics and Human Rights (UNESCO, 2005). The first is the obligation to satisfy the right to the enjoyment of the highest attainable standard of health without distinction of race, religion, political belief, economic, or social condition (Article 14). The second is to respect the fundamental equality of all human beings in dignity and rights so that they are treated justly and equitably (Article 10). The former seems to demand the provision of as much health care as possible to as many people as possible. But there are inadequate resources in the world to provide for all the health needs of all the people. As we endeavor to make decisions about the allocation of scarce resources, the complexities of the recognition and aggregation of benefits and harms present major challenges which threaten a mutual respect for these two obligations. This chapter endeavors to identify and disentangle some of these complexities in order to assist the search for equity, health, and well-being in accord with the declaration.


Health Benefit Septic Arthritis Body Dysmorphic Disorder Health Care Provision Political Belief 
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  1. ACT Health. (2009). Glossary. Retrieved February 2011, from the ACT Health Promotion website
  2. Daniels, N. (1985). Just health care. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  3. Derrett, S., Devlin, N., Hansen, P., & Herbison, P. (2003). Prioritizing patients for elective surgery. International Journal of Technology Assessment in Health Care, 19(1), 91–105.CrossRefGoogle Scholar
  4. Evans, D. (1995). Infertility and the NHS: Purchasers should avoid the moral high ground. British Medical Journal, 311(7020), 1586–1587.CrossRefGoogle Scholar
  5. Evans, D. (1996). The clinical classification of infertility. In D. Evans (Ed.), Creating the child (pp. 47–64). The Hague, The Netherlands: Martinus Nijhoff.Google Scholar
  6. Evans, D. (2008). In values in medicine: What are we really doing to patients? London/New York: Routledge-Cavendish.Google Scholar
  7. Evans, D. (2012). Academic freedom and global health. Journal of Medical Ethics, 38, 98–101.CrossRefGoogle Scholar
  8. Mill, J. S. (1910). Utilitarianism. In E. Rhys (Ed.), Utilitarianism, liberty and representative government (pp. 1–60). London: J. M. Dent and Sons.Google Scholar
  9. Mooney, G. H. (1986). Economics, medicine and health care. Brighton: Wheatsheaf Books.Google Scholar
  10. Nicholson, R. (1986). Risks and benefits in research on children. In Medical research with children (pp. 76–124). Oxford: Oxford University Press.Google Scholar
  11. Re C (Adult refusal of treatment) (1994). 1 All ER 819.Google Scholar
  12. Redmayne, S., & Klein, R. (1993). Rationing in practice: The case of in vitro fertilisation. British Medical Journal, 306(6891), 1521–1524.CrossRefGoogle Scholar
  13. Sassoon, S. (1961). The one-legged man. In Collected poems (p. 26). London: Faber and Faber.Google Scholar
  14. Singer, P. A., Salamanca-Buentello, F., & Daar, A. (2005). Harnessing nanotechnology to improve global equality. Issues in Science and Technology, Summer 2005, 57–64.Google Scholar
  15. Szasz, T. (1961). The myth of mental illness. New York: Delta.Google Scholar
  16. Taylor, P. (2000, February 6). My left foot was not part of me. The Observer, p. 14.Google Scholar
  17. UNESCO. (2005). The universal declaration on bioethics and human rights. Paris: Author.Google Scholar
  18. Walton, H. J. (1973). Abnormal personality. In A. Forrest (Ed.), Companion in psychiatric studies (Vol. 2). London: Churchill Livingston.Google Scholar
  19. World Health Organisation. (1946). Preamble. Constitution of the World Health Organisation. Geneva: Author.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.University of OtagoOtagoNew Zealand

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