Primum non nocere

Dr Gaurav Agnihotri

‘Primum non nocere’

Medicines is based on the tenet of ‘Primum non nocere’—first, do no harm. This sounds nice ,after all the doctors are healers and whatever they do should benefit the patient. However many physician’s opine that that the ‘harm of doing no harm’ can ethically tie a physician’s hands. The medical community continues to use therapies when the potential risks are outweighed by the potential benefits. The doctor’s in the modern era have their work cut out fighting antibiotic resistance and newer pathogens. The fact is that every medicine has side effects and every cure has a potential harm. This raises the question whether Primum non nocere is just a theoretical concept ,far from reality? Or are we ignoring the reality and sometimes overdoing treatment and procedures and inadvertently harming the patients. The present article will try to ignite thought on this issue and raise a few points which need to be discussed and are worth pondering upon.

We live in an era where the cost of medical education and equipment is continuously increasing. A modern doctor takes more than five years to graduate and then feels the need to do post graduation and super specialization. Doctors get a job by age 30 and after employment most get married. The expenses of married life coupled with the need to maintain a social status worthy of a skilled professional draws most doctors towards the commercial set up. Employment opportunities in Government set up are few and they do have their drawbacks. The commercial or corporate set up requires these doctors to fulfill targets. The already establish medical icons in these corporate hospitals become the role models of the new recruits. Gradually, these newer recruits establish themselves with hard work and conviction .The promotional campaigns by corporate houses often depict these doctor’s with  an aura of invincibility.Working in a environment where the patient’s and peers look upto them the doctor’s should never forget that they are ‘humans’ and there are’ limitations of medicine’. In the quest for commercial success the doctors and establishments need to keep in mind that their actions and excessive utilization of treatment modalities should not harm the patients. This is where the concept of ‘Primum non nocere’ becomes pertinent.