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The principle of nonmaleficence states a prohibition on causing harm to others in the absence of justifying circumstances. After surveying some prominent accounts of the nature of harm, we defend a counterfactual account: you harm someone if and only if you make them worse off than they would have been in the absence of your intervention. Using this account we specify nonmaleficence into several general moral rules corresponding to ways in which individuals can be harmed. These foundational reflections are followed by discussions of three areas of ethical concern in which rules concerning harm are prominent: (1) the ethics of torture, including health professionals’ involvement in torture; (2) the limits of permissible risk in pediatric research; and (3) the ethics of medical assistance-in-dying. We argue for a prohibition of torture, a specific risk ceiling for pediatric research, and a liberal approach, with various safeguards, to medical assistance-in-dying.
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