Issues & Insights

Above All, Do No Harm, In Medicine Or Politics


Physicians are taught in their training the principle, “First, Do No Harm,” one of the primary precepts of patient care, and which is found in early versions of the Hippocratic Oath. By contrast, many politicians seem to abide by the hypocritical oath, treating inconsistency, irrationality, and harm as incidental and subordinate to their self-interest. Lately, this approach to public service has become, literally, lethal.

Two prominent issues illustrate how embracing the hypocritical oath can inflict serious harm. The first is the handling of the pandemic, and the second is the dangerous distortion of the criminal justice system in many parts of the country.

It was just last year that numerous Democratic politicians, including then-vice-presidential-candidate Kamala Harris, stated unequivocally that a vaccine developed under President Donald Trump could not be trusted. It was as if she and others believed that the Trump administration’s career civil-servant regulators would cut corners and issue premature, risky approvals. Although there was pressure exerted on the FDA to act according to political timetables, nothing suggests that either product development or governmental review was inappropriately rushed.

Of course, after Joe Biden won the election, these same politicians could not pivot fast enough. Universal vaccination suddenly (and justifiably) became the mantra of the new administration. Unfortunately, some people seemed not to heed the volte-face, and the seeds of doubt planted last fall have borne fruit in the form of vaccine hesitancy. This is by no means an indictment of the vaccines. Rational people with no medical reason to hesitate should undoubtedly be taking the shot. The vaccines may not pose zero risk, but they are extremely safe; and for almost everyone, the risks of contracting COVID-19 are far, far greater, and prevention offers the added “bonus” of avoiding “long COVID” symptoms like fatigue, brain fog, shortness of breath, and loss of taste or smell, that persist in between 10% and 30% of those who recover from even mild cases.

The emergence of the Delta variant, which causes virus to accumulate in the nasopharynx in amounts at least 1,000 times greater than the original strain, is dangerous in two ways.

First, the higher viral load makes the virus more transmissible, so that even casual or brief contacts with someone who is infected is more likely to transmit an infectious dose than the earlier variants.

Second, higher viral loads make it more likely that a vaccinated person will encounter a dose sufficient to elude the protection afforded by the vaccines and cause a mild or moderate infection, and to more easily spread the disease. We saw that in July, when the summer holiday haven of Provincetown, Massachusetts, experienced almost 1,000 cases of COVID-19three-quarters of which were in vaccinated people.

Yet, because of the lost credibility of technocrats and politicians who seemed unable to communicate the nuanced realities of this disease, many people are unwilling to adopt measures, such as vaccination and masking, in order to reduce the spread of infections. Worst of all, those who choose not to be vaccinated, children who are too young, and people who are immunocompromised (and don’t mount a robust response to vaccination) are at extremely heightened risk of infection due to the greater transmissibility of the Delta variant.

Compounding the difficulties in implementing public health measures to control the spread of COVID-19 are statewide prohibitions (e.g., in Florida and Texas) on localities imposing mask mandates or on requiring that people be required to show proof of vaccination for attendance at public events or on cruise ships. These unwise and overly doctrinaire policies represent pandering to entrenched political constituencies, rather than reflecting scientific realities, especially in light of the characteristics of the Delta variant.

Thus, we have a public health crisis inflamed by politicians on all sides who have placed partisan objectives above public welfare, and, thereby, have undermined their credibility to respond to new threats. This is the opposite of “do no harm.”

The example above reflects politicians’ willingness to be irresponsible and to act contrary to the public interest in the face of an impending election or pandemic fatigue from restrictions and mandates. In a “can you top this” moment, our politicians and liberal elites have found other, more drastic ways to harm people: misguided attempts to reform the criminal justice system. In an incomprehensible, misguided attempt to compensate for (mainly urban) poverty and a degradation, most prevalent among minorities, of cultural norms such as nuclear families, emphasis on education, and personal responsibility, hypocritical politicians have taken actions that actually aid and abet criminal offenders to the detriment of the vastly larger, law-abiding population.

It may well be true that minorities sometimes have received harsher treatment from the criminal justice system, but proof of that is not, as is sometimes asserted, over-representation in jails and prisons. Some of the recent policy initiatives, which have included measures such as the elimination of cash bail, the downgrading of serious crimes to misdemeanor status, and the demonization and defunding of the police, have been harmful, especially to minority communities. Crime now often does pay … and with vanishingly small consequences in far too many American cities. Why work when you can waltz into a Target or Walgreen’s with trash bags, haul out $949 worth of goods (to stay under the $950 threshold for grand theft), not be stopped or accosted by security, and face minimal punishment even if you are the unicorn that gets caught and prosecuted. Absurd doesn’t do justice to this.

The consequences of these policies in terms of weighing the benefits to a small minority of often undeserving people versus the citizenry and commercial interests that are harmed are so clear that it is difficult to rationalize them. It is almost as though the politicians involved, and the dark money that funds them – George Soros being a prominent malefactor in this saga – have set out to hurt the very communities they claim to champion.

What we find especially disheartening is the number of people who are misinformed, ignorant, or apathetic about these and other examples of reprehensible public policy and irresponsible governance. If ever government could serve a public interest, it would be to educate the citizenry about the folly of supporting these kinds of policies and those who create them. Unlike many pandemic- and vaccine-related issues, the impacts of the weakening of law enforcement are glaringly obvious, but all are destructive.

“Your representative owes you, not his industry only, but his judgment; and he betrays you instead of serving you if he sacrifices it to your opinion,” said the 18th century Irish statesman and philosopher Edmund Burke. Our elected officials betray us when they follow the hypocritical path of pandering and self-interest.

Andrew I. Fillat spent his career in technology venture capital and information technology companies. He is also the co-inventor of relational databases. Henry I. Miller, a physician and molecular biologist, was the Robert Wesson Fellow in Scientific Philosophy & Public Policy at Stanford University’s Hoover Institution. They were undergraduates together at M.I.T.

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  • This guy lost all credibility when he started down the vaccine path. He is obviously just another sheep that can’t think for himself. Most people have natural immunity and everyone can take one of 3 known, safe, effective and cheap treatments to ward off a virus that really isn’t dangerous to the best majority of people. Heck, just having a healthy level of vitamin D have been PROVEN to stop or lessen the effect of the COVID. Very disappointed in I&I for publishing this article!!!

  • “Compounding the difficulties in implementing public health measures to control the spread of COVID-19 are statewide prohibitions (e.g., in Florida and Texas) on localities imposing mask mandates or on requiring that people be required to show proof of vaccination for attendance at public events or on cruise ships. These unwise and overly doctrinaire policies represent pandering to entrenched political constituencies, rather than reflecting scientific realities, especially in light of the characteristics of the Delta variant.”

    Apparently, this author has minimal reasoning skills…banning mask mandates or shot mandates does NOT mean people aren’t allowed to mask or get the shot – it only means people have a choice on whether to do so, based upon their own medical conditions and research. We see this everywhere – the panic porn promulgators really need to get a grip.

  • Much as I’m against blanket mask mandates, I do think that responsibility for the results of providing access to their ‘events’ lies with the events’ organizer – he, surely, is entitled to protect his other clientele, if only to avoid any subsequent legal actions.

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