First, Do No Harm

Primum non nocere, or, in English, “first, do no harm,” is a venerable maxim often traced to the Hippocratic Oath. It has long served as an important admonition in the ethics of physicians and other healthcare providers. It seems an eminently sensible rule. In a way it resembles the provision in Catholic moral teaching that one must not do evil in the hope or even the expectation that good will come of it.

The idea merits much wider application. Indeed, it would be a godsend if governments applied it to all their actions.

However, if applied consistently across the board, it would shut down government as we know it completely. Such involuntary government cannot even exist without first doing great harm, namely, compelling tribute from one and all for supporting the government, notwithstanding that many of those forced to pay may want nothing to do with the government and others may want the government but not value its services as much as they value the funds they are forced to cough up. In short, all governments as we know them rest on a clear wrong, namely, extortion (euphemistically called taxation), often supplemented by outright robbery in the form of fines, fees, civil forfeitures, and other confiscations backed by threats of violence against those who refuse to comply with the government’s demands.

Many people, of course, would not wish to apply the principle in this consistent, thoroughgoing way, being unwilling to give up the benefits they imagine themselves to be receiving from the government in spite of—but actually because of—its reliance on a wrongful means of supporting itself and channeling wealth to its chief cronies and dependents. Still, primum non nocere is a sound principle of action (or the lack thereof). Too bad it is not taken to heart and applied far beyond the doctor’s office.

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Addendum: Note that “first, do no harm” is a much more defensible maxim than one can derive from benefit-cost analysis. This common technique used by modern economists is utterly indefensible, not simply because it is nearly always twisted and shoved into supporting a desired conclusion by those who undertake it, but because even at its best it is economically incoherent because of its aggregation of individual costs and benefits to arrive at a social total that is, in fact, meaningless. Benefit-cost analysis would tell us that a government action is good if, notwithstanding its harms of some or all individuals (designated total costs), its total benefits outweigh them. But benefits and costs are intrinsically subjective and therefore relate to each individual, not to any group to which the individual may belong. Individual benefits and costs are not additive because analysts have no way to make Juan’s costs and benefits comparable with Maria’s. Benefit-cost analysis is a piece of consequentialist, utilitarian furniture that does not fit in a free person’s dwelling. It purports to provide an answer to the question of what government should do without actually considering the morality of the government’s action at all. It places no cost value on the loss of freedom occasioned by the government’s existence and any particular policy the government may implement. It is a true example of nonsense on stilts, however much it may be dressed up in vast volumes of data and impressive mathematical manipulations.