Posts Tagged ‘Do No Harm’

A prime directive for religions and politics: First, do no harm!

July 31, 2016

Primum non nocere – First, do no harm!

It is sometimes expressed aa “Above all, do no harm” or “Primarily, do no harm”. It used to be part of the Hippocratic oath for physicians as “… abstain from doing harm”. It is a phrase which is used mostly in a medical or psychological context but it seems to me it should rightly be a Prime Directive for virtually all human activity.

All human systems of law exist to make proper redress when a claim is made. For a claim to be made against anyone or any body of people, there must first be liability. Without liability there is no claim to be made. If no harm is done there is no liability. If this is the Prime Directive for all human kind, and if there is full compliance, it follows that having a system for handling claims and and redress becomes unnecessary. Note also that without harm being done, the question of ethical dilemmas does not arise. Generally law tells us what not to do and ethics tells us what to do. Legal and ethical dilemmas only arise because what law or ethics tell us to do can cause harm to someone. And as soon as harm is done, there is liability and there is a claim.

Not everything legal is ethical and not everything illegal is unethical. But we get a confluence of ethics and law if both adopt doing no harm as the foundation on which their structures are built.

If we must have religions, why cannot every religion have that as its prime Directive or Commandment number Zero? It ought to be the underlying tenet of every political party, of every association of people, of every corporate body, of every advocacy group or – even – of every charity. It ought to be the default codicil to every exhortation to action and to every purpose. “Seek happiness but first, do no harm” or “Make a difference, but first, do no harm” or “Make your fortune but first, do no harm”.

Of course it will be rationalised and circumscribed. “First, Do no harm” will nearly always become “Do no unnecessary harm” and you could argue that the concept of the use of force not being disproportionate to the task in hand is just that. In fact the concept of “being proportional” lies at the heart of our concepts of justice and fairness and “balance”. Even in war we require that harm be kept to a minimin. “Collateral damage” is to be minimised. Using disproportionate force is frowned upon. Attacking unarmed, non-combatants is not the done thing.

The practical reality is that human activities do, in fact, do harm to others. But that does not preclude any human activity from starting with “First, do no harm”. 



Psychologists do not swear any oath to “Do no harm”

December 14, 2014

Theoretically Doctors follow the Hippocratic Oath though I am not certain that all Doctors all around the world actually swear to do so. Psychologists and other therapists are not required to hold to any oath. They do not swear as many believe to “Do no harm”. So the two psychologists who designed and ran the CIA’s torture program and managed to extract $81 million for their services did not break any oaths. (Of course, $81 million for 2 people for 12 years is only $3.375 million per psychologist per year).  In any case any obligations to a patient did not and do not apply. Those being tortured were certainly not their patients – they were just subjects to be wrung dry. Medical Doctors were also around as reported by the Washington Post:

But in most instances documented, medical personnel appear to be enablers — advising that shackles be loosened to avoid extreme edema while a detainee was subjected to prolonged standing or stress positions; covering a wound in plastic during water dousing; and administering “rectal feeding” and “rectal rehydration,” which one medical official described as an apparently effective way to “clear a person’s head” and get him to talk.

The psychologists used the techniques developed by Martin Seligman on dogs. Learned helplessness is a behaviour in which an organism forced to endure aversive, painful or otherwise unpleasant stimuli, becomes unable or unwilling to avoid subsequent encounters with those stimuli, even if they are escapable.

Martin Seligman’s painful animal experiments and theory of learned helplessness began at the University of Pennsylvania in 1967. ….. In learned helplessness studies, an animal is repeatedly exposed to an aversive stimulus which it cannot escape. Eventually, the animal stops trying to avoid the stimulus and behaves as if it is helpless to change the situation. When opportunities to escape become available, learned helplessness means the animal does not take any action. ……. In CIA interrogation manuals learned helplessness is characterized as “apathy”

I suppose torture qualifies as painful and unpleasant stimuli.


Two psychologists contracted by the CIA to create enhanced interrogation techniques for al-Qaeda detainees have come under fire for violating human rights and medical ethics. Although pseudonyms were used in the 480-page report published this week by the Senate Select Committee on Intelligence, it was clearly referring to Bruce Jessen and James Mitchell, who were paid US$81 million for their work.

Both Jessen and Mitchell had worked on  the military’s Survival, Evasion, Resistance, and Escape (SERE) program in which soldiers are trained to endure brutal mock interrogations, including waterboarding. After 9/11 they were asked to design an interrogation program. …… 

The strength of ten

 The techniques they designed were based on the notion of “learned helplessness”, which was developed in the 1960s with dogs by Martin Seligman (who is mortified by his indirect link with torture). People who face unending adversity eventually become depressed and give up attempts to improve their situation. The CIA’s psychologists thought that this state would encourage detainees to become cooperative and volunteer information.

Physicians for Human Rights was highly critical of the participation of health professionals in all stages of the CIA’s program. Their involvement in monitoring the torture techniques was central to providing legal protection to interrogators, said PHR, as torture could them be described as “safe, legal, and effective”.

About half – if not more – of the US believes that the CIA torture program was justified even if torture – at heart – is wrong. I observe that the debate in the UK is about under what conditions torture may be acceptable, not on whether torture is wrong. In India, torture in the service of the State or of religion is implicit and considered justifiable. In Sweden torture is absolutely wrong and only to be used by others – where it may be justifiable. The prevailing Value which applies to humans as a whole, it seems to me, is that in certain circumstances, torture is regrettable but acceptable.

Human Rights are whatever a society determines it to be. The UN or European Human Rights conventions are supposed to be well meaning goals but that is all they are. Countries sign up to these conventions only because it is the “politically correct” and expedient thing to do. But what they truly  believe in is something different. Actual values determine actual behaviour. The conventions may represent “values we would like to aspire to” but they are not values that we do have. When Obama proclaims “That is not who we are” he forgets that what we do – not what we say – is who we are.

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