Nonmaleficence
Nonmaleficence is an ethical principle that requires caregivers to avoid causing patients harm. It derives from the ancient maxim primum non nocere, translated from the Latin, “first, do no harm.” Physicians today still swear by the code of Hippocrates, pledging to do no harm. Medical ethics require healthcare providers to “first, do no harm.” A New Jersey court, in In re Conroy,5 found that “the physician’s primary obligation is … First do no harm.” If there is no cure for a patient’s disease, the caregiver is often faced with a reoccurring dilemma. Do I tell the patient he is terminal and possibly cause serious psychological harm, or do I do my best to give the patient hope?
The principle of nonmaleficence is shattered when a physician is placed in the position of ending life by removing respirators, giving lethal injections, or by writing prescriptions for lethal doses of medication. Helping patients die violates the physician’s duty to save lives. Allowing death to follow its natural course can help solve the dilemma. In this instance, the patient’s caregivers can help ease the transition from life to death by providing comfort care and addressing the patient’s spiritual needs. For those who believe in an afterlife of peace and happiness, the transition will more likely be easier when one accepts that the patient is leaving one life to an even better life.
