Primum non nocere

Primum non nocere , also primum nihil nocere and primum nil nocere ( Latin , German 'firstly not to harm'; ancient Greek μὴ βλάπτειν mē blaptein 'not to harm' ), is a principle that the Hippocratic tradition puts at the center of its concept of morally required medical action provides (see also medical ethics ). The quote reads in full "primum non nocere, secundum cavere, tertium sanare", translated as "firstly do not harm, secondly be careful, thirdly cure".

According to this ancient motto, the doctor should, in his endeavors to help the individual entrusted to him , first of all take care not to harm him. Second, he should be careful or careful so that he can see exactly what is actually going on with the patient. Only then, thirdly, can he take the steps necessary for healing.

The doctor Scribonius Largus established this wisdom at the court of Emperor Tiberius Claudius around the year 50 .

The primum non nocere imposes limits on the use of medication or the implementation of medical measures. For example, no drug is guaranteed to work in the first place. With any drug, there is always a percentage of patients who will not receive the treatment effectively without any predictions. This percentage can be very small or close to zero, but it can also be well over 50 percent (for example in some cancers that are difficult to treat). In the case of the affected patients, one can say that the drug did more harm than good to the patient - the patient had to endure the side effects of the drug without benefiting from any effect. The solution to this ethical dilemma is, according to current perspective, the informed consent (Engl. Informed consent ) of the patient: if the patient after extensive education about side effects and the chances of success of a medical procedure or drug therapy approves the same, the doctor is legitimized ethically, they perform.

Primum non nocere

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