When Harm is Okay – An Armchair Ethics Post

The idea that we should not harm one another, and certainly not ourselves, can arguably be said to be a universally accepted normative claim. Certainly we know that it can cause both negative physical and emotional effects depending on the type of harm experienced. It could be said that this normative claim is in fact the most basic root of our moral reasoning. We do not for example allow for robberies because of the harm, and we do not allow for physical violence and bullying because of the harm. In its antithesis, we promote actions that heal and help others and ourselves. There are examples however, where helping people result in a negative outcome, and harming people results in a positive outcome. What is it therefore, that we can say changes the moral correctness of doing no harm, and being benevolent. This short post shares some thoughts on the topic of when harm is okay and is not only allowed, but the right course of action to take.

“First, do no harm” is attributed to the Hippocratic Oath although is more clearly written in Of the Epidemics by Hippocrates. Today, it really means that when performing surgery, drawing blood, and similar medical procedures, the benefits must outweigh the harms. A difficult calculation at times with Clinical Research although arguably not so difficult in mainstream medicine. We know now what is done in hospitals is for the good for the patient and Bioethicists working at hospitals throughout the world ensure a degree of compliance to this normative statement. Stemming from this historic normative claim, we have the Bioethical Principle of Non-Maleficence, and indeed also a Principle of Beneficence. So not only should we avoid doing harm, but we should active seek to benefit those being treated. This I think is a good foundation for other fields of study when applying ethical standards is required. We can say for example to the Political Scientist, when you govern, do no harm and only seek to benefit those you serve.

So we know there is a long standing tradition in medicine, but also in religion and morality in general, that we should not harm other people, physical or emotional, and we know that it is important to seek to help people and be benevolent. Is there a difference though of allowing something harmful to happen and causing it? Put another way, am I doing no harm if I just allow for actions to continue that I know will cause harm, or must I intervene. And if I cause harm, is it always wrong. On the face of it, it is clear that there is culpability when harm is directly caused, but some argue that allowing it to happen is different and should be seen and analysed differently. I would agree. In fact there is a clear dichotomy between passive and active when we allow for something to happen, instead of causing it to happen. This does not mean that both cannot be held responsible and share important consequences (if considering this action happens within a legal system) although there seems to be an intuitive diminishing of responsibility when it is passive. Is this always the case? I would say no. The reason for this, is when an individual can easily intervene, however, decides maliciously not to. I am of the mind that the all-important factor is maliciousness. Both passively allowing something to harm someone, and actively doing so, is wrong only in so far as the harm is the intended goal. This is how we naturally arrive at the Principle of Double Effect.

If there is a good end that can be accomplished through minimal harm, and the good end outweighs the harm that is necessary, the Principle of Double Effect allows for us to take action and cause harm knowing that the aim is not the harm itself but is an effect of achieving the good end. A classic example is if a person is confronted with violence, many agree that that individual can cause harm, up to killing the aggressor, because they are taking action to achieve a good end, that being self-preservation. The Principle of Double Effect, is not just some theoretical construct to avoid moral culpability. It is a recognition that intentions matter, and that some good ends require a lesser harm to happen. It is not of consequence whether this lesser harm is allowed to happen, or is directly caused in achieving the good end, as the intention is non-malicious. The person who is not the one who initiated the events into action can rightly do harm to achieve a good end and resolve it. What is of importance in terms of the Principle of Double Effect, is the known need to assure the actions taken are proportionate.

Harm, therefore, is okay when it is done not as a primary action, but as a side-effect of attaining a good end. The way we weigh the good end with the harm is not a simple matter and is subjective. This fact, however, does not mean we can arbitrarily say without careful reasoning and inspection, that the good end outweighed the harm. Through debate, discourse, time, and agreement, we can weigh these good ends as a society and make solid judgements on whether a harm was justified and “okay”.