> There is one other point that clearly falsifies the "first do no > harm" taken as an absolute rule for medicine. Take, for example, the > fact that there are always unknown factors and low probability events > in medicine. For example, even with the most common surgeries, there > is a chance the patient will die in surgery. Thus, if we first do no > harm, we never do surgery.
>I think "First, do no harm" is intended to be like something like the >law of the Iroquois Confederacy: "In our every deliberation, we must >consider the impact of our decisions on the next seven generations." It >acknowledges that there will be times when it is unclear whether the >decision to act now or to delay in performing a procedure on a patient >is going to "do harm". I think both yours and Nick's post are two takes on a liberal interpretation of that provisions; which does make sense in medical ethics. When I wrote the post, I was arguing against a "fundamentalist" use of that text, if you will. I know when Teri did her chaplan internship at M.D. Anderson, there were a lot of questions concerning medical ethics and there would be medical ethesists involved in working with the rest of the staff and the families on these decisions. So, I was arguing against a literalistic interpretation of the phrase itself, not the tough decisions you and Nick talked about. But, I would also argue that the "first do no harm" idea has morphed in society into a call for inaction until one proves no harm from something new in a number of areas. As Richard mentioned on the Culture list, there are inherently safer, cheaper forms of nuclear power that are rendered ecconomically unfeasible by the cost of satisfying safely test requirements of new designs, even when it is clear that newer designs are safer than what we are doing now. Or, the inability of NASA to adopt in a timely fashion more reliable technology because of the money and years it takes to pass official NASA reliablilty tests. Dan M. -------------------------------------------------------------------- mail2web - Check your email from the web at http://link.mail2web.com/mail2web _______________________________________________ http://mccmedia.com/mailman/listinfo/brin-l_mccmedia.com
