To First Do No Harm, Do Nothing First


First, Do No Harm

I am become more convinced that the best and possibly only truly good philosophy of right action is this one: Do No Harm.  As the title of the post proposes, we can likely only approach this philosophy by doing nothing.  Many actions are positively destructive, and so harmful.  I would like my actions to positively protect from harm.  That does not mean I intend to “do good” by my actions.

That may take some clarification, but the simplicity of starting with the this as a real first principle that one considers with honesty seems apparent.

I don’t mean “don’t do anything.”  As an organic being you must “do” when you eat and drink and talk and, etc.  In other words this is not a philosophy to govern your biological maintenance.  Rather, it is more properly a political and social philosophy.  I will try to expand a bit, but I would prefer that you take me seriously and challenge the meaning as you might apply it to your thinking about the things you do in life.  There are compromises at every turn and we can’t often practice what we preach as much of modern social organization nearly requires doing manifest harm (physical, economic, psychological harm) to ourselves and others.  For a brief example, I shop at a grocery store.  I am certain that this act alone is likely a small part of a chain of harm to many people and other creatures.  I can minimize this and be conscious of it in hopes of mitigating it.  Likely, I will continue this act but with an eye to doing less harm (and simply doing less).

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Primum non nocere is a Latin phrase that means “First, do no harm“.

Nonmaleficence, which derives from the maxim, is one of the principal precepts of medical ethics that all medical students are taught in medical school and is a fundamental principle for emergency medical services around the world. Another way to state it is that “given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good.” It reminds the physician and other health care providers that they must consider the possible harm that any intervention might do. It is invoked when debating the use of an intervention that carries an obvious risk of harm but a less certain chance of benefit.

The origin of the phrase is uncertain. The Hippocratic Oath includes the promise “to abstain from doing harm” (Greek: ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν) but does not include the precise phrase. Perhaps the closest approximation in the Hippocratic Corpus is in Epidemics: “The physician must…have two special objects in view with regard to disease, namely, to do good or to do no harm”…

I think it is likely an error to establish an equation of harms and goods as the above does.  I would also say that it is likely far easier to do harm than to do something wholly good that involves an “intervention” (see “The Grace of Gods By Force“). We make our actions good even as they harm in this way–as long as with some sophistry and statistical evidence we can point to the scales tipping to the good on our reckoning of costs and benefits.  It seems to me entirely impossible to do this without privileging one’s own perspective of the “good” being done.

David Bromwich, in his Introductory essay to his selection of speeches and letters of Edmund Burke, says Burke had a “single guiding maxim from which [he] never departed.  In every case, he warns his listeners not to interpret the rules of politics and morality in their own favor, and not to contravene the clear sense of right and wrong in the people they presume to govern.  One must never be the judge in one’s own cause…(italics in Bromwich).”

This seems a fair corollary to “do no harm.”  One can easily surmise that I will favor myself and/or my own worldview and my own calculus of costs and benefits when considering taking action.  Likely what I consider a good will count for more in my calculus than any harm that might be assessed in my equation.

Knowing little of Burke outside of his aesthetics I must admit that I must more properly be a Bromwichean as regards Burke’s political thought.  For example:

“Attentive as he is to the local texture of politics, Burke is the major theorist who seems least assured of the good of political activity….He believed that politics should be carried on as a steady business to protect it from becoming a constant imperative.”

I read that as a more consistent “conservative” consideration of politics as the steady “work” (rather than business, unless we see it as busy-ness) of a social practice with deep roots set against the “constant imperative” that is “reform” as “doing now” and with all speed.

This is further bolstered  by this: “I do not like to see any thing destroyed; any void produced in society; any ruin on the face of the land.”  Bromwich offers the gloss that Burke “often wrote as if the transition from nature to commodity were a passage in the depravation of human nature itself.  We are humanized by the time it takes to grow used to our own responses to things, and we do not have enough time if the stimuli change at too rapid a rate…”

Let us think on these as we consider our current moment.  We are working with all speed to change the social institutions around us, primarily our schools and our social welfare programs, with the singular intention of relieving our responsibility to self and community and replacing these with the “neutral” benignity of financial markets and scientific innovations.

Bromwich continues, clearly directing these words at this moment in history, and seeing it as coincident with Burke’s own:

No single person made society, nor has the latest generation; and by seeking to change it quickly and efficiently, we risk the creation of a mechanism void of the conditions that made it possible.  The self-contempt that is latent in such a policy will be legible in its effects….[Burke] believed that the long habituation of people to certain customs and practices yields a presumption in favor of continuing those customs and practices, and that this fact ought to be taken into account by any politician who does not treat his country as a field of conquest.  The making of sudden fortunes,…the wish to extirpate a whole way of life and reorganize all experience for the sake of money or efficiency or abstract rights: these are the tendencies of modern life…

All we need do is turn to the school reform movement that believes its time is now on the strength of its resources and political power to observe Burke’s warning in action as regards a “field of conquest.”  A void is being produced and filled with cold abstractions that persuade the many and favor a capital few while emptying out our humanity.

I would rather be doing nothing than participating in this.

*See the Errant archives for further missives on “doing nothing.

Photo Credit: sjardine

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2 Comments

  1. focus March 6, 2012 at 1:31 pm

    another medical aphorism for you: the enemy of “good” is “better”

    Reply
    1. Douglas Storm March 6, 2012 at 1:39 pm

      there you have the argument against progressivism.

      Reply

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