Among the things I love about Harrison's is the addressing of basic medical philosophy. Here is a quote from the introduction to oncology (Cancer Treatment). "The dictum primum non nocere is not the guiding principle of cancer therapy. When cure of cancer is possible, cancer treatments may be undertaken despite the certainty of severe and perhaps life threatening toxicities. Every cancer treatment has the potential to cause harm...the guiding principle of cancer treatment should be primum succerrere, "first hasten to help." (p.514)
Yes! The conflict I see played out in patients is a confusion between harm and treatment. Never have I heard an oncologist explain both the nature and the practical side effects of their treatments better. It would be wonderful to have this philosophy clarified, not because it's wrong, but because it would make it easier for patients to make quick decisions about their care. Yes, there will be side effects, but we need to
work fast. For those of you who don't know Harrison's is a standard medical text, interesting only to medical geeks like myself.