On Thu, Sep 3, 2009 at 9:09 AM, Dan M <dsummersmi...@comcast.net> wrote:
> > > There is one other point that clearly falsifies the "first do no harm" > taken > as an absolute rule for medicine. Take, for example, the fact that there > are always unknown factors and low probability events in medicine. For > example, even with the most common surgeries, there is a chance the patient > will die in surgery. Thus, if we first do no harm, we never do surgery. > > Clearly, I'm not arguing with you here, its just that your point made me > reflect a bit. > > I think you got this wrong, Dan. This is an area of ethics I'm well versed in, having been a paramedic (where it comes up constantly) and as a student of medical ethics. The reason your example doesn't falsify the absolute rule is that in your example, the surgery, the treatment, is the doctor's primary purpose, not the harmful side effects. That's exactly why it doesn't say "Do no harm." The word "first" is in there to mean that no doctor should do something in which the *primary* intent is to harm or the risk of harm exceeds the potential benefit (a hard call to make often). Thus, doctors have a real ethical dilemma if they even consider assisting in executions, court-ordered castrations and other areas where the primary purpose is indeed harmful, even fatal, and a somewhat less difficult dilemma when considering treatments with the possibility of unintended (or unknown) consequences. Nick
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