The first guiding principle we learn in life not only takes us all the way through medicine but the world as well: ethics. It’s not as simple as right versus wrong, even if we wish it was that way. The Latin phrase Primum Non Nocere (First Do No Harm) remains to be the main idea of the oath that physicians take when embarking on their medicinal journeys. But is it still relevant in today’s society?
The phrase ‘First Do No Harm’ appears in Hippocrates’ work, Of The Epidemic. Referred to as the father of medicine, Hippocrates (460-B.C - 376) was an ancient Greek physician who studied and wrote about the human body. Though nearly living 2400 years ago, his work stays relevant even in the Hippocratic Oath. The Oath, though going through many modifications, remains to keep many of the basic principles regarded by medicine.
What his work encaptures and what we eventually find most capable of understanding the nature of morals in this field are the basic principles of health care ethics:
Autonomy: Patients have the right to make informed decisions about their own medical care and are approached with confidentiality and veracity.
Justice: All patients must be treated equally.
Beneficence: Physicians must act in the best interest of your patient.
Non-maleficence: Physicians must not harm the patient.
The Hippocratic Oath specifies the principles of beneficence and non-maleficence and the rule of confidentiality. While it does not cover the basis of all ethics in medicine and is not widely recited in exact oath within modern-day practices, it still connects to many topics necessary to comply with the first rule of medicine: to overall do no harm.
However, in this day and age, what does that mean?
The concept has to be reasoned and applied to follow the other aspects that make up the ethical principle. It isn’t practical per se in a straightforward meaning, because in that definition we would see that the means of inserting an IV line by poking at the skin is avoidable for the bruises and bleeding that follows. In the same way, surgery is dangerous and can be detrimental at a specific moment.
Nevertheless, it is the best of medicinal duties to estimate and weigh the risks in the moment and for the future for the health of our patients and the system of care. While life-changing decisions are at the hands of a few individuals, it is up to everyone to make sensible and altruistic judgments so that we can continue learning as a society!
Read the Translated & Modern Version of the Hippocratic Oath here: