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Emerg Med J 2009;26:238-240 doi:10.1136/emj.2008.064303
  • Review

On the philosophy of diagnosis: is doing more good than harm better than “primum non nocere”?

  1. R Body,
  2. B Foex
  1. Emergency Medicine Research Group, Research Office, Emergency Department, Manchester Royal Infirmary, Manchester, UK
  1. Dr R Body, Emergency Medicine Research Group, Research Office, Emergency Department, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK; rbody{at}doctors.org.uk
  • Accepted 12 July 2008

Abstract

Diagnosis is arguably the cornerstone of medicine. Without at least some form of diagnosis the practice of medicine would not be possible. This narrative review explores common philosophical assumptions and challenges the notion that a certain diagnosis can ever be made. The idealistic concept of “primum non nocere” is discussed, and whether the utilitarian goal of achieving “the greatest happiness for the greatest number” is a feasible or preferable alternative is considered. It is concluded that utilitarianism is inescapably intertwined with modern medical practice. Suggestions are presented to further the understanding of diagnostic medicine by embracing its principles.

Footnotes

  • Funding: None.

  • Competing interests: None.

Responses to this article

  • The good and the harm.
    • michel g soete
    Emerg Med J published online November 22, 2010
  • On the philosophy of diagnosis: Authors' response
    • Richard Body,
    • Bernard Foex
    Emerg Med J published online February 16, 2010
  • When the Good of the One outweighs the Good of the Many
    • Jean Marc Benoit
    Emerg Med J published online February 16, 2010
  • Primum, non nocere.
    • Giles N Cattermole
    Emerg Med J published online October 22, 2009
  • It’s good, but is it utilitarian? A response to Body and Foëx
    • Kirsty Challen
    Emerg Med J published online September 16, 2009

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