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he principle of nonmaleficence states that we should act in ways that do not inflict evil or cause harm to others. In particular, we should not cause avoidable or intentional harm. This includes avoiding even the risk of harm. It is important to point out that this principle can be violated with or without intention. That is, you don't have to intend harm to violate this principle. In fact, you don't even have to cause harm. If you have knowingly or unknowingly subjected a patient or colleague to unnecessary risk, you have violated this principle (Munson, 2004).
Beauchamp and Childress (2001) point out the difficulty in defining the nature of harm. There are many types of harm ranging from physical and emotional injury to deprivation of property or violations of rights. In health care, the primary focus on harm relates to a narrower definition including pain, disability, or death. However, harm can be very much in the eye of the beholder, and a broader definition of harm is often required in ethical considerations.
Likewise, more than one level of harm may come into play in a situation. For example, a surgeon will inflict a level of pain and suffering on a patient in order to avoid their death. The surgeon has imposed one harm in order to avoid a greater harm. However, in all cases, we are prohibited from acting in ways that are likely to cause undue risk or needless harm.
For more on the principle of nonmaleficence see:
- Ascension Health - The Principle of Nonmaleficence
- University of Washington School of Medicine - The Principle of Nonmaleficence
