Is “do no harm” the most misunderstood phrase in medicine?

Psychiatrist Sabooh S. Mubbashar discusses his article, "Why 'do no harm' might be harming modern medicine." He reveals that the principle "First, do no harm," or Primum non nocere, is not part of the original Hippocratic Oath but a later, misattributed addition that has become a dangerously oversimplified slogan. Sabooh argues that a literal interpretation makes medicine impossible, as every intervention, from surgery to medication, technically inflicts harm. This creates a dissonance for clinicians and can paradoxically lead to overly aggressive care, especially at the end of life, where the pressure to "do everything" causes more suffering than benefit. The conversation explores how the interplay of this flawed mantra with patient autonomy and fear of liability can lead to choices that are legally defensible but ethically and clinically harmful. As a solution, he suggests returning to the oath's original, more honest language, which calls on physicians to use their "ability and judgment" to weigh risk and benefit, acknowledging that real ethics live not in mottos but in the nuanced, gray areas of clinical practice.

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