Archive for the ‘Introduction’ Category

September 6, 2011

Primum non nocere

Primum non nocere.
First, do no harm.

The Hippocratic oath is recited by rising physicians upon completion of their medical training and signifies the demarcation point of accepting the responsibilities of a medical degree.  It is often oversimplified with the simple phrase: first, do no harm. Primum non nocere.   Although these words do not appear exactly in the oath, this notion of nonmalficience forms the cornerstone of medical ethics.  Nonmalficience is generally balanced with beneficence, which describes actions done for the benefit of others. A far simpler way to state this idea is as risks verse benefits.   In the notion of treatment, and especially pharmacology, this balance IS the guiding principal.  If the risk of a medication outweighs the benefit gained by taking it or is more noxious than the illness being treated, you don’t prescribe it; but if the illness is so odious that peril in the lack of treatment outweighs the potential treatment’s side-effects, the medication is administered. A typical case in point is with most chemotherapy for cancer.  Chemotherapy essentially works by targeting and killing fast growing cells. In addition to the cancer cells, other fast growing cells are in the hair and gut- thus, the more obvious (side)effects of alopecia and anorexia, the usual outward manifestation of the cancer victim’s private fight. Untreated cancers usually have a high death rate.  In general, most people find hair loss better than dying, so chemotherapy, in spite of, or actually because of, its toxicity, is usually administered.    Where this balance becomes much grayer is in the field of psychiatry and mental illness, and especially child and adolescent psychiatry. Read the rest of this entry »

Category: Introduction