Wednesday, September 5, 2012

Do No Harm?

Have you ever read the Hippocratic Oath?  It is a greek medical text which basically covers the moral code by which most medical professionals will be sworn to.  However, it is fair to say that since its writing (presumed to be by Hippocrates, the father of modern medicine) and original translation it has been altered a number of times.

But the part that I would like to draw attention to is the part that says "Do No Harm."  I was talking to a doctor about this very point recently and it is something that many take very seriously.  After thinking about it though I think it is a huge contradiction.  Most medical procedures carry some form of risk.  Most drugs have side effects and all surgeries be they minor or major carry some form of risk which could be harmful.

So should the phrase be "Do No Intentional Harm"?  Well I think this too would be a contradiction.  I cannot think of a single surgery or treatment that requires hospitalisation.  I mean if we are going to be pedantic even a needle prick to administer IV fluids to an individual suffering dehydration is harmful.  And from here we can go all the way up the scale to major open heart surgery.  The point is it is always harmful.

On harm is defined as physical injury or mental damage.  But I think that we need to see beyond the literal definition and start to look at the intention of the phrase, which in my opinion should read like this, "Do No Intentional Harm that does not have an overall long term benefit to the patient".

I am sure that smarter people than I have hotly debated this topic in the past which is why most modern adaptations of the Hippocratic Oath do not carry the phrase.  But it is a debate that is quite close to my heart as my stem cell transplant is a harmful procedure that even carries the risk of death.  But for me the short term harm has been strongly outweighed by the long term benefit.

I have thought about this topic of discussion for a while but recent events have spurred me to write about it.  I guess there is a line that needs to be drawn where the risks and harm of whatever procedure is in question needs to be weighed up against the risks and harm that will be caused by inaction.  I'd love to have an answer for you but at the moment I stand conflicted.  As I process the information I will hopefully be able to draw some conclusions and when and if I do I will share them.  But for now stay well:)

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