Far be it from me –

First Do No Harm

on April 21, 2014

The Psychiatry SHO*

Sometimes people tell me that treatments like antipsychotic medication and ECT are unethical because they can have side effects. The Hippocratic adage “First Do No Harm” gets quoted as proof that no treatment that could harm someone should ever be prescribed.

And that would be fine, except that’s not what the old saying really means. Doctors would be in a tricky spot if it were. Every single treatment ever given to a patient has held the potential to cause harm – chemotherapy is a horrendous assault on a person; any operation could be terminal. Even taking a blood sample can cause bruising.

In reality, “First Do No Harm” (or “Primum Non Nocere”) is more complicated, and in fact, Hippocrates never even said it. The earliest known attribution is to medieval doctor Thomas Sydenham (1624-89) in an 1860 book by Thomas Inman.

In modern times we associate the famous saying with…

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