# Motivation and emotion/Book/2021/Beneficence as a psychological need

* Multimedia presentation (3 min)

## Overview

Reviews from many theorists across studies among [awkward expression?] Martela & Ryan (2015) suggest that beneficence is the sense of being able to give inherently and does improve well-being. Ryan and Deci (2018) disussed how prosocial behaviors are associated with enhanced well being. The mechanisms that explain this connection is evidenced from the self-determination theory to increase well-being and mediated by satisfaction of innate psychological needs for autonomy, competence, and relatedness. Findings from Vansteenkiste et al. (2020) together with Martela and Ryan (2015) propose that benevolent acts are driven by three innate psychological needs of competence, autonomy as one feels more connected with others and relatedness as one feels effective in helping which when satisfied yield enhanced self-motivation and mental health. When strained [missing something?] leads to diminished motivation and well-being. Martela and Ryan (2015) also illustrate that human beings are equipped with an inherent prosocial tendency that motivates and rewards us for benevolent acts and even toddlers are intrinsically motivated to act prosocially.
A study by Martela and Ryan (2015) showed that beneficence is associated with prosocial behaviors together with mechanisms such as love, humanity and promoting the good of others, explain the connection in the ability to give inherently enhancing wellbeing. In everyday language, the term "need" is used by humans [grammar?] Martela & Ryan (2015) to refer to desired outcomes for physiological, psychological health and well-being. Vansteenkiste et al. (2020) also describes the term "need" to denote the presence of a particular desire that is necessary for an organism to live a healthy life or preference often related to a deficit which varies in priority amongst people although universal. Another study by Vansteenkiste et al. (2020) and Deci and Ryan (2000) suggest that, [missing something?] beneficence the sense of giving inherently improves well being and plays a significant role in basic psychological needs with evidence from the self- determination theory showing that an increase in well being is mediated by the satisfaction from an innate psychological need of Competence, Autonomy and Relatedness. More so, according to the theorist Maslow, Van den Broeck et al. (2016) there is a hierarchy of needs for every human motivation that dictates a person's behavior known as the five psychological needs in terms of physiological (clothing, food ), safety ( job, security), love and belonging needs (friendship, love, family) and esteem (self actualisation )[grammar?].
* Focus questions:
* What is beneficence?
* Key motivation for beneficence and existing psychological needs
* Implications of basic Psychological needs showcasing beneficence on individuals

## What is beneficence?

Beneficence illustrated by Pieper and Thomson (2016) echoes utilitarianism as one benchmark for good outcomes and kindness in the promotion of the value of charitable works. Martela and Ryan (2015) together with Kinsinger (2009) all examine beneficence as actions or personal qualities with acts of kindness, generosity, charity, love and humanity with huge internal virtue in doing good to others with a moral obligation. Pieper and Thomson (2016) examine beneficence as one of the fundamental ethics in health care practice in line with the principle of beneficence to promote good, not harm and maximise possible benefits while minimising any potential harm on others.

#### Basic psychological needs

According to Van den Broeck et al. (2016) there are three innate psychological needs that drive human behaviour (competence, autonomy, and relatedness) which when satisfied yield enhanced self-motivation and mental health and are core aspects of the self determination theory. The criteria for basic psychological needs are (psychological, inherent, essential, distinct and universal) explained [missing something?] Martela and Ryan (2015) connected with beneficence the sense of being able to give inherently.

#### Build on literature

Researchers in the study of motivation describe three fundamental aspects of psychological needs that drive human behaviour Autonomy, Competence and Relatedness. Discussion around beneficence and existing psychological needs from Martela and Ryan (2015) explained that although well-being benefits of beneficence, it's partially explained by the sense of autonomy, competence, and relatedness, following results from study[grammar?] conducted after beneficence satisfaction was added to the mix, showing an independent effect on well-being across the studies[grammar?]. A multicultural comparison of the four pathways to meaningful work from Martela and Riekki (2018) [missing something?] three different countries, Finland, India, and United States across countries show that in quest for meaningfulness, we look for the intrinsic qualities of life that go beyond mere survival expressed through autonomy, competence and relatedness connecting to other people through caring relationships and being able to contribute in the society is ultimate to people for what makes life worth living.

## Key motivation for beneficence and existing psychological needs

The interest in the experience of well-being as both a research topic and a goal has significantly increased in recent decades, evolving into several psychological mechanisms that explain basic psychological needs and their connection with beneficence, the act of being kind as a moral obligation[grammar?]. According to Vansteenkiste et al. (2020), people have a limited set of basic psychological needs essential for flourishing and well-being, set at three: autonomy, competence, and relatedness are essential to developing and maintaining intrinsic motivation. A frustration of these three needs represented a more threatening experience than the mere absence of their fulfilment. Evidence from self-determination theory by Martela and Riekki (2018) shows that meaningful work is a key element of positive functioning influenced by four psychological satisfactions across cultures, notably autonomy (sense of volition), competence (sense of efficacy), relatedness (sense of caring relationships), and beneficence (sense of making a positive contribution). Beneficence is also a motivation for meaningful work argued Martela and Riekki (2018).

#### The three basic Psychological needs

The self determination theory explains basic psychological needs according to Van den Broeck et al. (2016) and Martela & Riekki (2018) as having three major important ingredients essential for ongoing psychological growth and well-being that plays a significant role and which fosters intrinsic motivation.
* Autonomy - freedom to make self choices which when satisfied gives a sense of integrity argued Martela and Riekki (2018)
* Competence - concerns the experience of effectiveness and mastery which becomes satisfied as one is of capably engaging in activities, experiences and opportunities extending skills and expertise noted Vansteenkiste et al. (2020) together with Martela and Riekki (2018)
* Relatedness - brings out experience of warmth, bonding, and care satisfied by connecting and feeling significant to others. A frustration comes with a sense of social alienation and exclusion noted Martela & Riekki (2018). Finally, Relatedness frustration comes with a sense of social alienation.

#### Maslow's motivational hierarchy needs

Maslow's hierarchy of needs studies how humans intrinsically engage in behavioral motivation. According to Van den Broeck et al. (2016), the most widely known academic model of needs was proposed by needs theorist Abraham Maslow, in 1943 that focused on internal factors to explain behavior describing the five basic psychological needs as essential and universal with emphasis on needs to be achieved from bottom to top for everyone to attain optimal potential. These hierarchy of needs are in terms of Physiological perspective (clothing, food, sleep, sex, hunger), safety (security, job), love and belonging needs (love, family, friendship), esteem ( self actualisation)(.Martela and Ryan (2015) along with Ryan and Deci (2000) suggest that human beings universality of need satisfactions across demographics are equipped with an inherent pro‐social tendency that motivates and rewards us for benevolent acts with research suggesting that even toddlers are intrinsically motivated to act pro‐socially. It only differs from individual on what priority of needs mean to them.
Unfortunately, there were limitations in Maslow's hierarchy theory as many behavioral scientists like VanDeVeer (1990) noted Maslow’s pyramid as not having as much contemporary theoretical importance nor was it universal in his discussion on claims that humans in order to survive experience needs across cultures in the same order firstly, food needs, shelter, and warmth since collective societies focused rather on social needs as more important than psychological needs. Hence, failed to recognise cultural and individual differences in that people experience these needs in different order[grammar?].

#### Intrinsic / Extrinsic motivation

Although self-determination theory based research primarily on intrinsic motivation Vansteenkiste et al. (2020) internal reasons for motivated behavior, later studies addressed extrinsically motivated activities reflecting on the extent to which people truly take in ambient values or practices [grammar?]. So both motivations are based on the different reasons and goals that give rise to action. Next, given the fact that to reach your full potential entails ongoing psychological need satisfaction, Martela and Ryan (2015) noted that, the biological psychological need theory has become relevant not only for intrinsic motivation and internalised motivation but also to well being. Ryan and Deci (2018) explained that for the full functioning of an individual, is a need for continuing psychological need satisfactions and basic psychological need theory relevant not only to intrinsic, internalised motivation but also to well-being more generally including prosocial tendencies. In contrast, offering external rewards for partaking in an activity can undermine intrinsic motivation because controlling rewards shifts one’s perceived locus from internal moves to external thereby weakening the sense of autonomy.
* Intrinsic motivation - Intrinsic motivation according to Vansteenkiste et al. (2020) and Ryan and Deci (2000) is the internal passion and motivation regulated behavior that requires a sense of effectiveness and autonomy satisfaction. In the absence of autonomy, one may engage in the activity to please others, get approval, or avoid feelings of guilt. Ryan and Deci (2000) also explain the self determination model of motivation and need satisfaction is linked with intrinsic motivation and foundations of nature which is inherent.
* Extrinsic motivation - Extrinsic motivation is behaviour driven by external rewards stated by Vansteenkiste et al. (2020) together with Ryan and Deci (2018) like fame, praise, money or avoid punishment not because it's enjoyable or satisfying but hope to get something in return.

#### Cognitive perspective

Neurological evidence from Martela and Ryan (2015) shows that decisions to act pro‐socially activate reward centers of the brain and based on such findings, suggests that the warm glow of giving may be a fundamental component of human nature. Feeling beneficent is an inherent and direct source of enhanced feelings of wellness. Research from Ryan and Deci (2000) and Vansteenkiste et al. (2020) indicate that human behavior is associated with these basic need satisfactions which tends to provide an adaptive advantage with psychological needs forming a fundamental part of an individuals’ functioning. Finally, findings from Vansteenkiste et al. (2020) show that individuals’ brain morphometry and the ventral stratum grey matter volume correlates positively with peoples’ experienced need satisfaction.

## Implications of basic psychological needs showcasing beneficence on individuals

The implications of basic psychological needs, benevolence in individuals is both positive and negative.

##### Enhanced well-being

A growing body of empirical work Martela and Ryan (2015) suggest that giving to others is beneficial for our own mental health and is associated with enhanced well-being and joy. Acts of beneficence include acts of kindness, volunteering, spending money on others, and research has shown that the emotional benefits derived from prosocial spending are cross-culturally seen to improve healthy development and emotions. Beneficent actions and motives, according to Pieper and Thomson (2016), have traditionally occupied a central place in morality, and common examples nowadays are found in social welfare programs, communal support of health-related research, scholarships for needy and meritorious students, policies to improve the welfare of animals, disaster relief, programs to benefit children and the incompetent, and preferential hiring and admission policies. More so, a growing body of empirical work by Martela and Ryan (2015) also suggest that giving to others, acts of kindness, and spending money on others are beneficial for our own well being, along with prosocial behaviour. Meaningfulness as regards life and meaningfulness as regards work are facets of the same psychological construct argued Martela and Riekki (2018).

##### Great experience

Beneficence is one of the drivers of any public health system (Pieper and Thomson, 2016), the ideal that people within a society should promote health in general as a social good to others and more specifically, provide a level of health-care for the disadvantaged in society and to do harm, is not the same as actively providing benefit. Beneficence is the principle of research merit, justice and integrity explained Pieper and Thomson (2016).

##### Actualise our potential

Meaningful work is a key element of positive functioning in employees examined Martela and Riekki (2018) based on research on self determination theory, basic psychological needs and prosocial impact of beneficence across cultures with illustrating data from Finland , India and United States in terms of autonomy, competence, relatedness and beneficence and results showed that all four show satisfactions are significantly and independently associated with meaningful work. From literature we can see that we see that meaningfulness as regards life and work are facets of the same psychological construct (Martela and Riekki, 2018).

##### Healthy development

According to Pieper and Thomson (2016), beneficence is the most important principle of human nature with a designated class of virtues rooted in goodwill, generosity, and love directed at others, with moral psychology and virtue ethics as foundational motives of benevolence across manifestations of friendship, charity, and compassion, amongst others. Vansteenkiste et al. (2020) investigated the importance of satisfying psychological needs in fostering psychological growth, integrity, and wellness noting that physiological needs such as hunger and thirst must be fulfilled to grow and thrive physically.
The consequences are both positive and negative. Failure or frustration of these basic psychological needs not met at various hierarchy stages, according to Maslow (Martela and Riekki (2018), can lead to mental health issues such as anxiety, depression, post-traumatic stress disorder, or psychiatric illness, potentially leading to death or extreme illness. Also, Ryan and Deci (2000) explain that beneficence frustration is correlated with indicators of ill-being (negative affect, depression, anxiety, physical symptoms).
However, the connection disappears when controlling for the effects of autonomy, competence, and relatedness. Needs and frustrations have an impact on happiness. This leads us to suggest a distinction between basic psychological needs and basic wellness enhancers with beneficence, the satisfaction of improved well-being. Martela and Riekki (2018) explain that being able to experience meaningfulness is a fundamental part of having a life worth living, and a lack of meaning is associated with depression, mortality, and even suicide confirming that employees around the world seek to find meaningfulness in their work, with family as one of the most important domains from which people derive meaningfulness in their lives.
Negative are, failure or frustration of these basic psychological needs not met at various hierarchy stages explained Martela and Riekki (2018) by theorist Maslow, can lead to mental health issues such as anxiety, depression, post-traumatic stress disorder, anger, frustration, or psychiatric illness, potentially leading to death or extreme illness. Also, Ryan and Deci (2000) explain that beneficence frustration is correlated with indicators of ill-being (negative affect, depression, anxiety, physical symptoms). However, connection disappears when controlling for the effects of autonomy, competence, and relatedness. Need frustrations have an impact on wellbeing. This leads us to suggest a distinction between basic psychological needs and basic wellness enhancers, beneficence the satisfaction of improved well-being. Martela and Riekki (2018) explain that being able to experience meaningfulness is a fundamental part of having a life worth living and a lack of meaning is associated with depression, mortality, and even suicide confirming that employees around the world seek to find meaningfulness in their work, with family as one of the most important domains from which people derive meaningfulness in their lives.

## Case study

Challenges case managers face in honoring autonomy and beneficence (client legal right versus client cognitive ability)
* Case Scenario:1
* A case manager has become aware that her client’s driving skills have deteriorated to the point at which he constitutes a hazard to the community and himself. As a health professional (case manager), at what point in the case management process is it best to intervene, especially when the intervention might result in a restriction of the client’s desires, preferences, or liberties?
All would probably agree that a case manager who becomes aware that her client’s driving skills have deteriorated to the point at which he constitutes a hazard has a professional obligation to report this to some authority, such as the client’s physician and supervisor. Driving an automobile, raising children according to one’s values, living by oneself and engaging in intimate relationships are indicative examples of a person’s self-determination autonomous rights. When these rights are revoked, a person may react with feelings of anger or even vengeance toward those trying to help. Taking steps that gear towards annulment of someone’s driving privileges can be an extremely unpleasant undertaking and can result in the professional's losing of that individual as a client. However, managers need to be actively aware of the impact of the client’s cognitive condition on autonomy, and be able to take appropriate steps to protect both the client and their own welfare of removing harm and doing good showcasing beneficence.
When you are caring for clients who are unable to exert autonomy (like clients who lack judgemental capacity or have been so adjudicated by the courts and are incompetent), must ensure that you are coordinating the clients’ care with whomever is legally authorised to do so. Usually, a next of kin, a designated health care proxy, or a court-appointed guardian identified in state law as the one authorised to make medical and healthcare decisions on the client’s behalf.
The duty of beneficence is that the health provider does good in what's best for the patient's own good. Beneficence is defined as kindness and charity to ensure that the client in her care is assured of all the benefits of her professional knowledge to help the person overcome their dysfunction to the extent that clients are reasonably autonomous. Once the clients’ cognitive faculties fails and can no longer exercise autonomy because they cannot adequately understand or reason the consequences of their decisions, healthcare professionals or their surrogates become responsible for what happens to them. As a result, beneficence in health care encourages health professionals to take responsibility for their decisions in what is best for the patient's own good, demonstrating kindness and charity to benefit others.
* Case Scenario: 2
* On beneficence
* An external nurse field case manager for Mike M, an extremely difficult patient whose treatment requires active use of all my ethical principles. Mike is now 48. When he was 27, he was struck on his neck, head, and arm by a chain or cable at work, sustaining an acquired brain injury. He was comatose for 5 months after the injury and was declared permanently and totally disabled. Mike has been diagnosed with depression (for which he takes Paxil) and has slurred speech, balance difficulties, and impulsive behaviour. He lives in his own single-story home in a small town in Washington and has a care provider a few hours a day. He had been in an assisted living facility before he moved away from Seattle to return to his childhood location.
* Five ethical principles govern case management (Autonomy—the patient’s freedom to choose his or her own treatment course, Beneficence—the case manager’s responsibility to promote good and be the patient’s advocate, Nonmaleficence—first, do no harm, Justice refers to fair and objective treatment, while veracity refers to telling the truth.
* Michelle Nielsen addresses four interconnected issues regarding ethics in case management: professional integrity, dual relationships, weighing of beneficence, autonomy, and future harm. The reason that noncompliance is an exercise of the patient’s right to self-determination. Moreover, they rationalise that, if they continue to pursue the patient’s good despite noncompliance, they will be patronising the patient.
* (Nielsen, 2002)
Nielsen’s case analysis showcases a subtle understanding of the relationship between the principles of beneficence and respect for autonomy.
* Take home message on the criteria of beneficence
* Beneficence as examined by Kinsinger (2009) is as an act of kindness, mercy, charity and kindness with a strong connotation of doing good to others including moral obligation. According to VanDeVeer (1990) as well as Pieper and Thomson (2016) autonomy is "a dominant principle" in medical ethics and elaborates that all professionals in medical ethics have the primary moral obligation of doing right with beneficence being one of the fundamental ethics driven by the self determination theory values. Sometimes people may not always have the ability to exercise their autonomy (VanDeVeer, 1990).

## Tables

Table 1.
Key aspects to note arising from beneficence in Case Study 1
| Beneficence | Duty of beneficence | Duty of beneficence |
| One's actions should promote good Not inflicting harm Action done to benefit others Kindness and charity Intrinsically driven Balancing benefit of treatment against risks Create a safe and supportive environment Removing harm | One's actions should promote good Not inflicting harm Action done to benefit others Kindness and charity Intrinsically driven Balancing benefit of treatment against risks Create a safe and supportive environment Removing harm | Beneficence and the professional's moral imperative argued Kinsinger (2009) takes active steps to promote and benefit the welfare, good of the client's support system when appropriate without malice, prejudice nor urge for external rewards. |
Table 2.
Checklist on beneficence(good,charity,volunteering) intrinsically driven
* Other beneficence checklist
* Talking to the community about sexually transmitted diseases
* Providing vaccination kits during the COVID 19 pandemic
* Helping out in a fire outburst
* Encouraging people to quit smoking
* Rescuing a drowning victim
* Giving food to the needy

## Quiz

Test on the following terms and concepts:
* Beneficence (kindness and charity)
* Code of ethics for health care professionals showcasing beneficence and intrinsic motivation
Quiz
1
What does beneficence mean?
To do good
To be honest
To promote personal freedom
To keep one's promises
2
Which principle of research ethics discusses actions intended for the good of others?
Beneficence
Nonmaleficence
Justice
Autonomy :

## Conclusion

Pieper and Thomson (2016) and VanDeVeer (1990) amongst many explain that the term beneficence describes personal qualities of mercy, kindness, generosity, and charity and is suggestive of altruism, love, humanity and promoting the good of others. So, the notion is broad and even more broadly used in ethical theory to effectively include all norms, dispositions and actions with the goal of benefiting or promoting the good of other persons. Van den Broeck et al. (2016) also adds that the self determination theory (SDT) requires that each psychological need does uniquely predict psychological growth, internalisation and well being for optimal potential of a personal.