Non-maleficence is a core principle of medical ethics stating that a physician has a duty to ‘do no harm’ to a patient. It directs a medical professional to consider the benefits of all procedures and weigh them against the potential risks and burdens on the patient.
The concept of non-maleficence is derived from the Latin phrase “primum non nocere” (“first, do no harm”). It can be applied to assessing the risks of medical procedures – or ensuring that all treatments and medical advice are administered by professionals with appropriate qualifications.
The need to learn and gain practical experience is also often correlated with the pillar of non-maleficence. The medical industry has set out protocols to allow students to gain knowledge in a safe manner while minimising the risks for patients. As such, students should abstain from undertaking complex assignments prematurely or performing tasks outside of their practice scope.
Non-maleficence differs from beneficence in two major ways.
First of all, it acts as a threshold for treatment. If a treatment causes more harm than good, then it should not be considered. This is in contrast to beneficence, where we consider all valid treatment options and then rank them in order of preference.
Second, we tend to use beneficence in response to a specific situation – such as determining the best treatment for a patient. In contrast, non-maleficence is a constant in clinical practice.
For example, if you see a patient collapse in a corridor you have a duty to provide (or seek) medical attention to prevent injury.
One of the best ways to understand the difference between non-maleficence and beneficence is by looking at an ethical example:
A 52-year-old man collapses in the street complaining of severe acute pain in his right abdomen. A surgeon happens to be passing and examines the man, suspecting that he is on the brink of rupturing his appendix. The surgeon decides the best course of action is to remove the appendix in situ, using his trusty pen-knife.
From a beneficence perspective, successful removal of the appendix in situ would certainly improve the patient’s life.
But from a non-maleficence perspective, let’s examine the potential harms to the patient:
It is important to remember that before leaping to action, we need to consider the implications and risks of intervening at all.
Ethics will come up in your interview, and you need to think about non-maleficence. You should consider:
Some questions you could be asked at an interview include:
You can find the answer to these questions – and more – in our ethics questions and answer guide.
Some hot topics that would apply to non-maleficence include:
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