Great emphasis, in clinical medicine, is placed on the second half of Hippocrates’ time honored injunction: primum non nocere, or “Above all, do no harm.” This dictum, incidentally, was not commonly used until popularized by Dr. Thomas Syndenham in 1860.
For reasons that aren’t clear, physicians rarely are called on to memorize the full sentence–which emphasizes –first!–doing good:
“The physician must be able to tell the antecedents, know the present, and foretell the future — must mediate these things, and have two special objects in view with regard to disease, namely, to do good or to do no harm.”
Dr. Robert Schmerling, in a blog post for Harvard Health, points out that to “do no harm” is a low bar; and so indeed it is; but it is important to recall the other “special objective”–to do good.
Moreover, physicians do not work in a vacuum: their work is dependent on an army of pharmacists, pharmaceuticals, medical devices, hospitals and staff and insurance companies–and every part of that structure is critical to their success–to their doing good and not doing harm.
In light of the recent but by no means most egregious medical device failure, a CPAP machine whose malfunction resulted in showering patients lungs with known carcinogens (problematic pharmaceuticals are likewise not uncommon; an example is albuterol inhaler contamination and faulty dosing that may have resulted in serious harm to patients) — perhaps it is time to call for a universal Hippocratic Oath: that all who have any association with the practice of medicine be called on to follow the Hippocratic guidance, like physicians: their two objectives could be “to do good or to do no harm.”
If faithfully applied, such an oath would result in all of those in the medical system working together as a team for the common good. Imagine how much less overwhelmed emergency departments and hospitals would be, with all energies redirected toward a common goal. This would benefit medical care.
And above all–this would benefit patients.
