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
 Theargument 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:
 Theability 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..