Many professionals and scholars within and beyond the field of medicine have analyzed the principle of Non-maleficence with a view of reviewing and improving the same.

Non-maleficence does not operate alone but is aided by other principles such as beneficence, autonomy, and justice. All these principles work together in harmony to create a base of medical ethics. The definition and specifications of non-maleficence may vary with jurisdiction but the general agreement is that the principle forms the foundation of medicine. Depending on the laws of a country, violating this principle may lead to the government revoking ones medical license or even imprisonment.


The principle of non-maleficence requires that doctors, nurses or any persons in healthcare should ‘above all do no harm.’ The term is associated with the moral obligation not to create undue harm just because one has the power to do so. This principle ensures that patients receive honest care from healthcare providers. It also ensures that the medics take personal responsibility over the life of their patients. All the benefits put aside, this principle has been the subject of criticism by many philosophers. This essay will look into some of those criticisms and analyze their arguments for and against the principle of non-maleficence.


Holm (2012) argues that the principle of non-maleficence is general and without construct rules. For example, there are no specifications on when one should uphold the principle and when one should not follow the principle. This is because, according to her argument, it is impossible to avoid harm to all persons at all times. Although Holm underscores the importance of acting responsibly, she also points out that it is difficult to please all people at the same time. She asserts that the principle has important and genuine concerns on ethics but at the same time it has flaws that make it impossible to execute efficiently (Holm, 2012).

Lustig (2009) argues that non-maleficence expresses the need for medics to avoid inflicting pain but to concentrate on reducing pain. Lustig notes that non-maleficence is not just a philosophical but also a moral principle that defines the society. However, he expresses reservations about the lack of clarity in the principle. He states that it may be difficult to define the term ‘harm’ since it cuts across many boundaries. Harm may be in relation to emotional, physical, or even spiritual borders. This principle does not specify what type of ‘harm’ a medical practitioner should avoid. In addition, Lustig notes that the principle does not define the degree of harm that one should avoid in their practice, leaving loopholes for distorting this rule of medicine (Lustig, 2009).

Gillon (2011) observes that medics have given this principle undue priority over other principles of medicine. He notes that non-maleficence is important in setting medical ethics. However, he argues that it is not as important as other principles such as beneficence (Lustig, 2009). In his view, the latter which means ‘doing good’ should have more priority than ‘avoiding harm’. This is because, he adds, doing ‘good’ is more practical than avoiding ‘harm’.


Non-maleficence has been applied in the field of medicine and it is considered a core principle in medical ethics. These requirements bind the practice of every doctor, surgeon, or general medical provider. This sacred tenet of medicine puts all the healthcare providers under obligation to always avoid making decisions that would bring harm to their patients. Critics have argued that non-maleficence lacks elasticity and specifications on its requirements, a factor that could create loopholes in the principle.


Gillon, R. (2011). Primum Non nocere and The principle of ‘Non-maleficence’. British Medical Journal , 130-131.

Holm, S. (2012). Not Just autonomy – The Principles of American Biomedical Ethics. Journal of Medical Ethics , 332-338.

Lustig, A. (2009). The Method of ‘Principlism’: A Critique of the Critique. Journal of Medicine and Philosphy , 487-510.

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