" first, do no harm." primum nil nocere.
Non-maleficence, which is derived from the maxim, is one of the principal
precepts of bioethics that all healthcare students are taught in school and is
a fundamental principle throughout the world. Another way to state it is that,
"given an existing problem, it may be better not to do something, or even to do
nothing, than to risk causing more harm than good." It reminds the health care
provider that they must consider the possible harm that any intervention might
do. It is invoked when debating the use of an intervention that carries an
obvious risk of harm but a less certain chance of benefit.Non-maleficence is
often contrasted with its corollary, beneficence.
Origin: The origin of the phrase is uncertain. The Hippocratic Oath includes
the promise "to abstain from doing harm" (Greek: ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ
εἴρξειν) but does not include the precise phrase. Perhaps the closest
approximation in the Hippocratic Corpus is in Epidemics:[2] "The physician must
... have two special objects in view with regard to disease, namely, to do good
or to do no harm" (book I, sect. 11, trans. Adams, Greek: ἀσκέειν, περὶ τὰ
νουσήματα, δύο, ὠφελέειν, ἢ μὴ βλάπτειν).
According to Gonzalo Herranz, Professor of Medical Ethics at the University of
Navarre, Primum non nocere was introduced into American and British medical
culture by Worthington Hooker in his 1847 book Physician and Patient. Hooker
attributed it to the Parisian pathologist and clinician Auguste François Chomel
(1788–1858), the successor of Laennec in the chair of medical pathology, and
the preceptor of Pierre Louis. Apparently, the axiom was part of Chomel's oral
teaching.[3]....Source: Wikipedia.
Bizden Canan, MD.
2 Nis 2015 tarihinde ÖÖ 4:12 saatinde, Chris Walsh chris@xxxxxxxxxxxxx
[ConstellationTalk] <ConstellationTalk@xxxxxxxxxxxxxxx> şunları yazdı:
Dear all
Maria I applaud you for raising this difficult issue at a time when you must
be feeling quite vulnerable.
I agree with Robert that we have to be careful that we don't hide our real
responsibility behind some metaphysical woo woo. People do die from suicide
and clearly it is sometimes unavoidable. Nonetheless, we sometimes do make a
difference.
We know from our constellation work that some people are caught up in
entanglements that pull them towards death. Other people simply suffer from
depressive suicidality without any discernable entanglement. Despite that,
many of these people don't commit suicide and live productive lives. Of
course we are interested in what makes the suicidality go away and what
pushes someone over the edge. And it is true that an unskilful intervention
from a friend, family member, therapist, constellation practitioner or
friend can push someone over the edge. A bit of bad luck can do the same. One
of my underlying ethics is not to cause unnecessary pain, suffering or harm.
Constellation Talk is full of emails of people talking about how
constellations have made a positive difference to people's lives. Here's the
newsflash. It can also make people's lives worse. Let's begin to look at that.
The greater soul does not protect the participant from the facilitator's
ego. And it is very hard to remain honestly aware of the workings of our egos
in this work. It is easy to overlook the limitations of our skills. It is
easy to superimpose some restricted worldview that we have on the
constellation we are supervising. I personally have seen and heard of these
things happening. I am sure I have been guilty of it myself. In one of the
incidents where a client committed suicide after seeing Bert Hellinger, many
observers thought that Bert's intervention was insensitive, brutal and
unskilful and was probably directly responsible for that client's subsequent
death. If we are to stay in our integrity I think we have to stay open to the
fact that these assessments may even have been valid. It is because we are
all vulnerable to these sorts of distortions and because they can sometimes
have terrible consequences that we need ethics, accountability and ongoing
training and supervision.
In the end it is true that we cannot know how much any one factor contributes
to a person's suicide. It is also true that it may have been inevitable. It
may even be true that a suicide is part of some greater mystical movement.
But let's not use these possibilities as trite platitudes to avoid taking
responsibility and to avoid learning from experience.
Cheers
Chris Walsh
Melbourne, Australia
ph +61 (0)3 9487 4647
www.cwalsh.com.au
On Wed, Apr 1, 2015 at 10:20 AM, Robert Grant erebees@xxxxxxxxx
[ConstellationTalk] <ConstellationTalk@xxxxxxxxxxxxxxx> wrote:
Dear Friends,
Language is important if we aim to be honest with ourselves. What was needed
and what has transpired are not the same. Life may unfold as it must and
indeed greater forces may determine outcomes. To say however that an
inevitable outcome was needed is once again a fundamental denial and
avoidance of our actual responsibility and reality, and therefore it is a
step towards dishonesty. It also deprives us of seeing how thing could be
made to work better.
Are we not inventing and projecting limited human qualities onto a greater,
maybe even unfathomable reality, in our desperate scramble for a sense of
acceptance? How amazingly convenient it is to say in the face of our utter
powerlessness and ignorance that well, this disaster is exactly what was
needed.
Best wishes to all,
Robert
On Wed, Apr 1, 2015 at 8:38 AM, 'Blossoming Heart Intuitive Arts'
heather@xxxxxxxxxxxxxxxxxx [ConstellationTalk]
<ConstellationTalk@xxxxxxxxxxxxxxx> wrote:
Hi Maria,
I'm so sorry to hear about the suicide of one of your patients. Thank you
for raising your concerns and the code of ethics you have as a doctor. I can
imagine it would be difficult to negotiate if you were to recommend patients
to do Constellations work, as this is unconventional spiritual work that
views life and death through a different lens than the medical field.
Ultimately we cannot control whether a person commits suicide. All the help
in the world, including your attempt to help your patient with introducing
them to Constellations work, may not prevent them from going ahead towards
that fate. I don't know how much experience you have with Constellations,
but perhaps it would be best to be a participant first so you can feel
familiarity and understand the deeper wisdom for a while before making
recommendations to your patients so you can stay true to your first
obligation as a doctor.
This work cannot be contrived or controlled extensively. From my experience,
its intention isn't to heal but rather to bring deeper understanding to the
higher flow of life, balance and what we do for love. There can be healing
effects or a person can change life directions because of the
acknowledgement of the system, but it's not intended to promote wellness
like the medical professional states.
Your inner conflict and negotiating your role as doctor and participant was
exactly what was needed for that weekend you were on. Trust your limits,
inner voice and what you can and cannot control is part of the greater
movement.
Thank you for your contribution,
Heather
-----Original Message-----
From: ConstellationTalk@xxxxxxxxxxxxxxx
[mailto:ConstellationTalk@xxxxxxxxxxxxxxx] ;
Sent: Tuesday, March 31, 2015 10:31 AM
To: ConstellationTalk@xxxxxxxxxxxxxxx
Subject: [ConstellationTalk] ethics and constellations
Dear all,
As a result of the suicide of one of my patients short after a constellation
done by a colleague, I want to rise an ethical issue.
As a physician, at least in Belgium, we are ALWAYS responsible for our
patients. I raised this issue before the start of the workshop I organized
for my colleague. This responsibility makes, that even if the colleague does
the constellation, I'm still the physician of my patients. My colleague did
not agree that I participated as the physician of my patients. His idea was
that I was as one of the other participants. Seen I could not take my
responsibility towards my patients, I stayed home the second day in order
not to disturb the ongoing workshop.
With the feedback of my patients, with the suicide in mind, the issue that I
want to rise is the following:
As a physician we have full responsibility for the well-being of our
patients, promote their health and relieve their pain.
The position is different for a psychologist or another care-giver.
As a physician, whatever treatment we use, including constellations, we
always have full responsibility for the treatment we choose and our
patients.
Second point is that patients always have to ask for help at the physician
in the first place. So, as a physician we are not allowed to send them
emails with invitations for workshops.
It's clear for myself that I was not acting in line with the ethics of my
profession that particular weekend. I placed the wishes of my colleagues
above the ethics of my profession.
Whether my presence at the workshop could have prevented this suicide, we
will never know.
For myself, it feels as very important that the ethics of my profession
could be recognized by colleagues doing constellations.
Mieke
Maria Goossens, MD
goossens.maria@xxxxxxxxxx
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