PRIMUN NON NOCERE: First Do No Harm

Primun non nocere. This is still the sacred promise of every medical school graduate across the country as he or she accepts the diploma, the title and the rank of healer in our culture. It is the core of the Hippocratic Oath. However, in a world of unreasonable speed, in which new discoveries and new pharmaceuticals are being produced in measures of seconds, not years, it may be more than doctors can promise us anymore.

What Does Do-No-Harm Require?

One, beyond the obvious deliberate misdeeds or malicious negligence being called to � ���"do no harm� �� � requires at the very least a reasonable skepticism. This means that a physician� ��"or any professional providing a treatment, especially a pharmaceutical one� ��"should question whether that treatment has the right stuff to do what it's touted to do. Does it cure what it says it's going to cure? Or do people have one symptom go away only to have another (often more dangerous) one appear? Is there an actual need for the pharmaceutical or is it a drug being sold because of a massive fear campaign? Do the independently financed studies back up what the marketing departments say?

Two, the physician ought to be capable of weighing the risks and balancing the promised benefits against the delivered dangers. Does it reduce the pain of rheumatoid arthritis but give you a statistically significant chance to get cancer? Does it give you a longer-lasting erection but negatively impact your cardiovascular system? Does it give you a shorter menstrual period but lead you towards ovarian cysts?

And finally, the physician MUST ask: Is this safe? Will this product or procedure actually harm my patient?

The Current State of Harm

On July 13th of this year, the World Health Organization (WHO) presented the global media with their recommendations on the H1N1 vaccines. A small part of their � ���"guidance� �� � as George A. Ure called it in his piece,Calm Before the (Cytokine) Storm, were three points that are pertinent to this article:

1. All countries are being called upon to forcibly immunize health care workers as a tier-one strategy to guard the infrastructure should a pandemic materialize.

2. Since current production is insufficient, they are recommending a laddered approach to � ���"immunization� �� � starting with pregnant women, children of 6 months old with one of a few specific medical conditions, healthy young adults 15 � ��" 49 years of age, then healthy children, then healthy adults 50 � ��" 64 years of age and finally the elderly.

3. Because some of the pandemic vaccines have been created with new technologies which have not yet been properly studied for their safety in certain population groups, the WHO is strongly urging post-marketing surveillance.

Next Page  1  |  2  |  3  |  4