🥑Beneficence

Beneficence is a core principle in medical ethics that guides providers to act as they believe is in the best interest of the patient. It encourages all interactions with the patient to be beneficial and of good to them. It is important to bear in mind the patient’s expectations when recommending treatments, as doing “good” not only means what is medically good for the patient but also what is acceptable treatment to them.

Unlike non-maleficence, it goes beyond simply doing no harm. It encourages healthcare providers to actively help the patient by considering their unique circumstances and what is good for one patient may not necessarily be so for another.

In the context of children and young people, they may be coerced into SOGIE-change efforts by their parents. In these contexts, healthcare providers should assess the best interest of the patients. They should refrain from suggesting harmful interventions, including so-called conversion therapy and medical interventions and take measures to prevent harm against the patient. This could include explaining the harms of conversion practices to the patient’s parents, family counseling, among others.

What can healthcare providers do to ensure beneficence when treating LGBTQIA+ people?

Offer LGBTQIA+ affirming care services, and ensure access to all facilities without discrimination or prejudice. This includes ensuring transgender people’s access to facilities based on their gender identity.

Keep yourself updated on the latest information on LGBTQIA+ affirming care and SOGIESC. Look for information in the event that you need to know more.

Take proactive measures to increase trust, availability and accessibility to LGBTQIA+ affirming care. This includes revising forms, making your healthcare facility safe, equipping yourself with knowledge.

Case Study: Beneficience

Physically abused by a family member as a teenager for his sexual orientation, a gay refugee from Palestine, Amir* sought help from a UNHCR-provided counselor, but was instead retraumatised. The counselor, who was not LGBTQIA+ sensitized, victim-blamed Amir* for the abuse, “You should not disobey him (the family member), you should listen to him. In Islam being LGBT is haram, you should at least acknowledge that.”

Key Takeaways

• Stigma, religious demonization, victim-blaming and lack of culturally-appropriate and LGBT-affirming care can deter LGBTQIA+ people from seeking healthcare services. This can further exacerbate health conditions.

• A person can have a religious identity and be gay at the same time. They should not be forced to choose one identity over another. If healthcare providers are uncomfortable providing care and treatment for LGBTQIA+ patients, they should refer the patient to others who could provide them the support that they need.

Source: No safe haven: What it’s like to be an LGBTIQ+ refugee in Malaysia (Queer Lapis, 2023)

*Names changed to protect confidentiality