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The ‘Do No Harm’ principle: So simple? So easy to misunderstand!

'Do no harm' principle-Hippocrates
Frank Vibert

Frank Vibert

OXGS Fellow; an associate of the Centre for the Analysis of Risk and Regulation (CARR) at the London School of Economics

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The views expressed are solely those of the author (s) and not of Oxford Global Society.

The maxim ‘do no harm’ (DNH) is enjoying a surge in popularity. From its early use in the Hippocratic Oath and medical ethics, its deployment has now extended to other areas including bioethics more broadly, education, the environment and internet ethics. It is held to apply to the decision-making of all actors, from individuals and corporations to governments and their regulators.  A striking contemporary example is provided in the context of the EU’s Action Plan to achieve carbon neutrality by 2050. The key regulatory measures in the Action Plan on sustainable finance provide that ‘the precautionary principle of ‘do no significant harm’ is ensured’.

The canonical statement on harm occurs in JS Mill’s Essay ‘On Liberty’ where he sets forward ‘One very simple principle’. In summary form this reads:

 ‘The sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of their number, is self-protection…the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others’.

On Liberty (1974), pp. 68-69, Penguin Books.

According to some commentators it is the apparent simplicity of the principle that accounts for its lasting popularity.

Mill enunciated his ‘do no harm’ principle in the context of an analysis of the individual in relation to collective decision-taking by society. As a consequence, much of the subsequent discussion of the principle has been set within the context of Mill’s contribution to the liberal tradition. The maxim can also be placed within the framework of Mill’s theory of knowledge. This provides a different perspective.  A focus on knowledge places the justification of policy interventions in relation to the application and development of a society’s state of knowledge.

When viewed according to the liberal tradition as a demarcating principle between choices that belong to the private sphere and choices that belong to the public sphere the application of Mill’s apparently ‘one very simple’ do no harm principle has long been criticised as not simple at all. Similarly, from the perspective of Mill’s theory of knowledge, this principle is also not simple at all. It can easily be misunderstood.

The ‘Do No Harm’ principle does not justify an individualism that is unreceptive to the views of others. On the contrary Mill insisted on the need for individuals to engage with those who hold contrary opinions. Nor does it justify indifference to the findings of science. Mill insisted that our ethical precepts should be informed by the sciences. Neither is it correct to see it as a simple precautionary principle providing a sweeping justification of public policies that aim to protect people against future bad possibilities. Mill wrote, ‘The preventative function of government… is far more liable to be abused, to the prejudice of liberty, than the punitive function’. Mill’s warning is against public policy relying too heavily on scientific projections that might prove to be wrong.

According to Mill’s theory of knowledge the ‘Do No Harm’ principle is a derivative of three overarching epistemic principles: An ‘infallibility’ principle that states that our claims to certainty in the social and natural sciences must always be seen to be open to disproof; a ‘corrigibility’ principle that in order to achieve progress in the real world we must have procedures that allow us to correct received understandings, policies and practices; and, a ‘vitality’ principle that we need our authority structures to advance our understandings by encouraging open discussion and ‘experiments of living’.

The ‘Do No Harm’ principle sits at the end of this chain of logic as the basis for ‘vitality’. It has continued relevance in the world of policy making today by pointing to these overarching principles. It is the overarching principles that provide the measure of how far public policy is likely to be well founded, or not. The EU’s Action Plan on sustainable finance is only partly consistent with these criteria.

Download the full research paper in PDF, which looks at the sources of the ‘do no harm’ maxim in political economy.