musings on…primum non nocere

In Medicine, Musings, Philosophy on Tuesday, 26 February 2013 at 07:04

for years, I have been hearing people “quote” a portion of the hippocratic oath that referencing “first do no harm” as the main point and an exact quote.   while not the type to directly correct someone, especially about something that i think a majority of people believe,  and it just makes me look like a philosophical snob or elitist.  that said, i heard someone mentioning the “first, do no harm” portion in conversation and ascribing it to the hippocratic oath again yesterday which precipitated this posting.  i don’t believe that people deliberately want to misquote or mislead others as this seems to be a generally held belief.

for the record, the original version of the hippocratic oath is as follows:

“I swear by Apollo the Physician and Asclepius and Hygeia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parent and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant; to give share of precepts and oral instruction and all other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else.

I will apply dietetic measure for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give a woman an abortive remedy. In purity and in holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite be my lot.

Hippocrates (c. 460–c. 370 B.C.).  The Oath and Law of Hippocrates.
The Harvard Classics.  1909–14.

as one can see in the oath the passage “I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing” and “In whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm” (pp. 299, 301) IMPLIES to do no harm but the exact wording “first do no harm” (in latin, “primum non nocere”) is not in the hippocratic oath.

Hippocrates (c. 460–c. 370 B.C.).  The Oath and Law of Hippocrates.
The Harvard Classics.  1909–14.

clearly, there is an explicit and implicit understanding in the oath to “first do no harm” however, this is not part of the hippcratic oath.  the mention not doing harm IS in the hippocratic corpus.  not that there isn’t controversy surrounding the corpus as its true authorship is a much-debated topic, but we will ascribe it to hippocrates as some of the greatest philosophic scholars can not say for sure.  it has actually been postulated that many ‘authors’ had their hand in writing the many books of the corpus.  even so, the corpus is largely associated with hippocrates and we may never know for sure whose work it was or who contributed to it.

alas, for now, I leave you with the part most have come to accept of as one of the main points of the hippocratic oath:

in  latin, “primum non nocere” which literally means “first do no harm” is seen in one of the books of the corpus .  “As to diseases, make a habit of two things—to help, or at least to do no harm. The art has three factors, the disease, the patient, the physician. The physician is the servant of the art. The patient must co-operate with the physician in combating the disease.”

Hippocrates, Epidemics, book 1, section 11.—Hippocrates,trans. W. H. S. Jones, vol. 1, p. 165 (1923).

so, now you know if you didn’t already!

  1. Thanks, because I didn’t know.

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