First, Do No Harm…
Posted on Monday, August 27th, 2012
From time to time, we invoke the phrase “first, do no harm,” commonly attributed to the Hippocratic Oath. But if you want to get strict about such things, this isn’t really accurate. In fact, nothing like the phrase occurs in the modern version, though the classical includes a promise to keep “the sick” from “harm and injustice.”
Still, the basic concept seems fundamental to the healing arts (and perhaps this explains why it’s so easy to associate it with the Oath): If your goal is to help someone heal, the last thing you want to do is hurt them. It’s antithetical.
This is why issues of biocompatibility, for instance, loom so large in biological dentistry. We want to be sure that the materials we use to fill or restore a specific patient’s teeth won’t trigger an allergic or immune response. At the same time, we want to be sure that all materials we choose are free of general toxins such as BPA.
What inspired us to take a fresh look at the Hippocratic Oath was a recent Wealthy Dentist survey which asked US and Canadian dentists “if they are concerned about the safety of dental composite and sealants.” (Composite – white/tooth-colored filling material – is used for sealants.)
Amazingly, 54% aren’t.
Said one California dentist, “I didn’t know that I need to be concerned….”
Another dentist referred to those who are concerned about such things as “wackos.”
In fairness, most comments shared were more professional than these, regardless of opinion. Still, you would hope that all dentists would at least be aware that there are concerns about some forms of composite, just as there are concerns about mercury amalgam.
As for the Hippocratic Oath – which dentists typically take, as well as physicians (though some may use a version written to be specific to the art and science of dentistry) – here’s the complete modern version:
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
Image by Shakko, via Wikimedia Commons