First, We Do Harm: Obtaining Informed Consent for Surgical Procedures.

Area of Science:

• Medical Ethics
• History of Medicine
• Surgical Consent

Background:

• The phrase "first, do no harm" (Primum non Nocere) is widely misattributed to the Hippocratic Oath.
• Its origins trace back to 17th-century medical literature, not ancient Greek texts.

Discussion:

• Many medical interventions, including chemotherapy and invasive procedures, intentionally cause initial harm for long-term patient benefit.
• This practice highlights the ethical principle of nonmaleficence, which involves striving to maximize good outcomes while minimizing harm.

Key Insights:

• Surgical operations inherently involve inflicting initial harm with the goal of achieving a greater overall good for the patient.
• The ethical justification for surgery rests on this calculated balance of harm versus benefit.

Outlook:

• The understanding of "Primum non Nocere" underpins the development of modern informed consent procedures.
• Informed consent acknowledges the patient's understanding and acceptance of potential harm for anticipated therapeutic gains.