Friday, January 28, 2011

First, Do No Harm

Primum non nocere is a Latin phrase that is a foundational element of the Hippocratic Oath (the pledge taken by new doctors). Although the exact origin of the phrase in unknown, the essence of its translation is extremely important: "First, do no harm." In other words, when a problem presents itself, it may be better not to do something, or even to do nothing, than to risk doing more harm than good. Medical students are taught this under the principle of nonmaleficence in medical ethics, especially when it comes to emergency medical services.

An example of this concept in practice can be seen when a professional sports player sustains a serious injury. Team trainers have learned to use precautionary measures when tending to the injured player. They are concerned, first and foremost, with not making the injury worse. Especially in the case of an apparent neck or spinal injury, they do not want to exacerbate the problem by forcing the body into a position that could cause permanent damage. Therefore, they start by simply immobilizing the body, and only engage in further action when more is known. Such an approach has not only helped in saving professional sports careers, but also in saving lives. While this concept is generally connected to the medical profession, it can apply just as well to other areas of life.

People have often debated which formulation of the Golden Rule is better: the positive formulation (i.e. love your neighbor as yourself), or the negative formulation (i.e. do not do unto others that which you don't want done unto you). While the positive formulation certainly sounds nicer, why is it that a Torah scholar like Hillel preferred to use the negative formulation? When articulating the underlying principle of Judaism, he said, "What is hateful to you, do not do to your neighbor. This is the whole Torah! The rest is commentary. Now, go and study" (Shabbat 31a). Couldn't he have simply said something to the effect of "Love other people" as the opening line?

Herein lies the wisdom behind Hillel's response. Instead of driving ourselves crazy trying to figure out all the details of how to act lovingly toward others, a negative formulation of the Golden Rule forces us to think about how we would feel if we were on the receiving end of our own interpersonal conduct. For example, before speaking harshly about someone else, a person should consider whether they would find it okay if someone else spoke in such a manner about them. Engaging in this quick ethical test is within everyone's capacity. This could also be the reason why most of the Ten Commandments are phrased as "Thou shalt not." It may not sound as pleasant, but it is infinitely more effective.

This is not to overlook a sage like Rabbi Akiva, who uses the positive formulation, "To love your neighbor as yourself is the major principle of the Torah." However, after people hear such a statement, they often wonder how to properly fulfill the commandment. For example, does it mean we are obligated to love every single person, both Jew and gentile, both good and evil, and if so, to what extent? The questions are endless, and it can take a lifetime of study to uncover sufficient answers. However, when people hear a negative formulation of the Golden Rule, it becomes much easier to incorporate into their daily lives. First, the basic value of not hurting others is inculcated, and then one can go on to learn all the details of how to lead an ethical life. As Hillel states, "The rest is commentary. Now, go and study."

Before we can be good people, we must first not be bad people. Or, to put it another way, before we do a specific action, it would be wise to ask ourselves whether or not our behavior will inflict harm on someone else. Anyone can rationalize that their intentions were pure, but few people can withstand the unforeseen consequences of their actions. The more we interfere in the lives of others, the more of a chance we may hurt them. Obviously, this doesn't mean that we should shy away from helping those in need. It simply means we have to be fairly certain that what we're doing has a good chance of actually helping. Remember . . . primum non nocere.

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