Harm.-hippocrates Oath What Does This Statement Imply

¶ … harm."-HIPPOCRATES OATH

What does this statement imply for both the patients and the doctors?

The idea of 'first, do no harm,' as stated in the Hippocratic Oath, is considered one of the oldest, perhaps the oldest principle of medicine. Doctors are supposed to be healers, not harmers of the human body. No ailing person should go to the doctor fearing that he or she will be taken advantage of, because of his or her vulnerable position as a patient. A patient should not fear that information will be withheld from him or herself, as part of an experiment, as was the case in the infamous Tuskegee Syphilis study in which patients with the condition were knowingly denied treatment. Patients will fear going to physicians if they are terrified they may leave sicker or more damaged then when they entered treatment.

Physicians may make mistakes, some treatments may be ineffective, and prescribed treatments have changed over the eras for various conditions. Once upon a time, very invasive and aggressive action was undertaken for cancers that can now be treated with much milder forms of radiation therapy. But when the more aggressive therapies were used, the physicians were still striving to do no harm, given that was thought to be the best treatment available at the time. Similarly, in extreme situations when only primitive tools of treatment are available, physicians may not be able to give the optimal remedy. But still they must strive to do no conscious harm.

Doing no harm does not mean complying with the patient's every wish. For example a plastic surgeon may be asked to give breast implants to a sixteen-year-old girl with the consent of her mother. The surgeon perceives the girl is too young to make such a decision, even though her parent is giving her consent. The girl is still developing, and seems to be insecure in her sense of self. Performing her request would do her harm, and she would likely regret it later on. Of course, many might protest that all plastic surgery is a form of harm to the patient, since much of it is medically unnecessary and for aesthetics alone. This controversy highlights the subjective nature of what it means to 'do no harm.'

Another example of doing no harm that is controversial is the question of physician-assisted suicide or even withholding heroic means to preserve life. Some consider this a violation of the dictate to do no harm because the life of a patient is ended. However, advocates of the practice state that patients should have the right to die with dignity and to deny them this right is to do harm.