Primum Non Nocere-
What it really means
Anyone who knows those of us at Advanced Pediatrics knows that we
love what we do — helping families get and stay well.
Over the years we have been in practice, we have come to better
appreciate this principle taught to every medical student in the United
States: primum non nocere
—first, do no harm.
While we spend much of our time helping cure a child's illness, easing
someone's discomfort or suffering, preventing a problem from occurring, and
offering counsel that helps, many possibilities exist today that could cause a
degree of harm — even if slight. Thus we make a real effort to follow the
dictum of primum non nocere.
So it came as a real shock to read the report released this week
(in mid-July of 2015) by the American Psychological Association (APA) into
their own investigation of a pattern of behavior by senior officials of the APA
— past presidents, and the head of their ethics division. The report describes
that these leading American psychologists gave official APA sanction for the
use of “…harsh and abusive techniques…” on prisoners, in an effort to secure
and maintain lucrative contracts from the Department of Defense and CIA.
Here is a link to the actual APA report:
The use of harsh and abusive techniques on prisoners of war may be
controversial to some, but the notion that some of our country's top mental
health professionals would essentially sell out their professional for money is
not. The most troubling aspect of this situation is that it is not surprising.
For many years, we have heard of hospitals making decisions that
favor profits over good practice; and of doctors taking drug money in exchange
for studies with, recommendations of, and prescriptions for profitable
medicines. The new motto of the day seems to be primum pecuniam, first
money, rather than primum non nocere, first do no harm.
The good news is that this fundamental violation of what it means
to be a health care professional was investigated and reported by the same
organization whose leadership created the breach, the American Psychological
Association (APA). Sadly, I remain skeptical.
While it is unlikely this particular breach will happen again, I
doubt that past presidents of the APA and past chairs of their ethics
committees will go on record and admit their role in this insult to our
healthcare creed.
As a family member of Advanced Pediatrics, you can remain secure
in the knowledge that we honor first do
no harm. And that we will continue to pursue policies that attempt to keep
the marketplace as far from any medical decision making as possible. This is
why we when we opened, we created the self-regulating guideline of accepting no
items from any pharmaceutical company. And why we try to base all our
information on direct readings of the scientific literature, and not through
the lens of any particular organization. This is also why we offer direct
on-call access to Dr. Hertzer and me, and will not sign up for distant nurse
call centers.
We are pleased that the APA has issued this report, but dismayed
that leaders of such high stature could have missed so thoroughly the obvious
obligation that being a healthcare professional entails. Advanced Pediatrics is
an infinitesimal part of the medical professional landscape, but within our
small arena, we will continue to make the obvious choices the right ones,
namely, that the care of your family comes first.
In these times when trust is questioned so
often, we are all the more grateful for the trust you have given to us.
To your health,
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