non-maleficence (primum non nocere)x

Non-maleficence

Prepared by:

Zamirah Basher

Principles of biomedical ethics

Hippocratic oath to current

medical ethnics

I will follow that system of regimen, which,

according to my ability and judgment, I

consider for the benefit of my patients,

and abstain from whatever is deleterious

and mischievous. I will give no deadly

medicine to anyone if asked, nor suggest

any such counsel.

(Primum non nocere) That into whatsoever house you shall enter, it

shall be for the good of the sick to the utmost

of your power, your holding yourselves far

aloof from wrong, from corruption, from the

tempting of others to vice.

Lets start by defining..

The principle of “Non-Maleficence” requires an intention to avoid needless harm or injury that can arise through acts of commission or omission. In common language, it can be considered “negligence” if you impose a careless or unreasonable risk of harm upon another

Do no harm !!!

Physical , mental

moral

DUE CARE

Taking sufficient and appropriate care to

avoid causing harm , as the

circumstances demand of a reasonable

and prudent person

NAGLIGENCE

Two types

1. Intentionally , which is an unreasonable risk

of harm

2. Unintentionally , by carelessness

Due to absence of ‘due care’ , leads to

professional malpractice, because physicians

are not following the professional standard care

Moral dilemmas

Situates the moral

dilemma with

which physicians are

faced in real life

circumstances.

Case 1

Male patient of his 40s suffering from advance and

terminal skin cancer,

the patient is experiencing acute pain.

If his physicians continued with the current and

standard line of treatment, he would live for about a

year and probably more

but all the time he would be in acute and unrelenting

pain.

The physicians decided to purpose a stronger pain killer

, that have unintended effect of shortening the patient

life.

Argument

The argument usually made in favour of

physicians when they help to relieve pain

and suffering with double effect drugs

that hasten death is that it is the

physician’s obligation to alleviate pain

and suffering. Patients (and Indeed

everyone) have the right not to suffer

when it can be avoided.

Another side of the story

would be..

It is argued on the other side of

the divide that physicians must at all times

adhere to the code of medical ethics not to

inflict harm, that is, the obligation of

nonmaleficence.

On the use of double effect medications

in relieving pain and suffering, it might be

necessary to know the innate quality of

human life in general and particularly the

quality of human life at the moment of death.

Case 2 2 year old male, physical deformities and mental

retardation, the physician informed that he would probably have lived to his fifth birthday but not more.

Parents have no formal education and are working at a factory with a monthly salary of US$500 , to sustain their life and another 3 children with no health insurance

Monthly expense for medication and special diet for the child is US$450

The parents have requested for the physician to let the child die as the child could never live a normal life, the physician consented the request.

stop giving the child his medication and diet

The child died after 2 days

Have the physician

breached the obligation

of Non-maleficence

The physician can argue that

he follows the parents request

due to the fact that:

The ability of the family to support the

child is really low as they also need to

feed another 5 mouth and the other 3

child need to go to school and they are

prone to be suffering from malnutrition , its

morally wrong for the other child to suffer

as well

But …

physicians

inflicted harm, even if on compassionate

grounds, hence, the moral dilemma remains.

I must say…

It seems the moral

dilemma remains: whichever way the

pendulum swings, the physician must at all

times be conscious of the dictum: aegroti salus

suprema lex (that is, the good of the patient is

the highest law)

reference

https://tspace.library.utoronto.ca/handle/1807/6766

http://depts.washington.edu/bioethx/tools/prin2cs.html

http://www.lutz-sanfilippo.com/library/counseling/lsfnonmaleficence.html

http://priory.com/ethics.htm

Thank you yeaaa..