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Nancy S. Jecker, PhD
Seattle, Wash

JAMA. 1993;269(23):2986-2987.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—I appreciate Dr Baughan's thoughtful letter and agree with the spirit of his suggestions for further elaborating the analysis of beneficence as it applies to the care of battered patients. My argument was not that justice should replace beneficence and nonmaleficence in the ethical analysis of domestic violence, but that the analysis should be broadened to include justice assessments.

Baughan recommends that "the concept of beneficence be elaborated to consider effectiveness" and intimates that narrowly conceived interventions that focus exclusively on the individual patient may be ineffective and hence futile. The remedy then is caring not only for the patient, but for the family as a whole, including family members responsible for violence toward the patient.

However, the idea of futility does not imply, as Baughan suggests, that an intervention does not produce an effect or change in the patient's condition. Rather, futility means that an intervention does . . . [Full Text PDF of this Article]

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