I Took An Oath To “Do No Harm” – Not “Save Lives”

Early in my medical training, my colleagues and I had our rite-of-passage into medical school by taking the Hippocratic Oath at our White Coat Ceremony. Many associate the words “do no harm” with this oath; however, this phrase is nowhere in the original reference. Although the text has been translated countless times over the centuries, this is the closest version I found alluding to the “do no harm” mantra:

“Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies.”

That was the focus: help the sick without doing harm.

In contrast, these days healthcare is romanticized by the never-ending pursuit to “save lives” and only fueled by the media (think of all the medical dramas on television!) Coming from someone who actually works with critically ill patients in the operating room and ICU trying to balance an imperfect science with humanism, I’ve come to realize just how frail the human body is. No amount of health, youth, or power can nullify the potential effects of a single overdose, traumatic event, or impulsive decision. Truly “saving a life” is a rare event compared to our ability to comfort and promote wellness.

We need to do a better job of emphasizing the quality of one’s life over quantity from the very beginning of training! The general public needs to understand that treatment is often more harmful than curative. Just because we can do something doesn’t mean we should. Every patient encounter is an opportunity to build a relationship with the individual, their family and caretakers, and understand exactly what their goals are. What do they want with life? What do they want to get back to doing? How can we get there together? What pitfalls can we expect along the way? These are all incredibly important discussions to have as a multidisciplinary group, so we can genuinely be acting in our patients’ interest instead of fulfilling our own goals.

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