Ethics - First Do No Harm

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FIRST DO NO HARM BOOK REVIEW

Zizette C. Howard

Department of Nursing Herzing University

NM 410: Ethics In Nursing

Professor: Sandie Yeager

February 8, 2022

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Book Review Do No Harm

One of the ethical principles for healthcare workers is ‘Do no harm,’ the principle is

applied to all healthcare workers, doctors, surgeons, nurses and other people working in a

healthcare facility. However, the main question to be analyzed is, ‘when is life worth living?’

There are a lot of questions pertaining the issue of ‘do not harm,’ and sometimes it leads to a

dilemma among healthcare workers. ‘First, Do No Harm,’ is a book by Lisa Belkin, that gives a

close examination of how life and death decisions from the perspectives of the family, doctors

and nurses. The book takes the audience through the hallways of a major hospital where Belkin

explores challenging issues concerning medical ethics. The main aim of the book is to present

the ethical dilemma faced by healthcare givers as well as family members in the healthcare

setting.

‘First, Do No Harm,’ is a story that gives a real-life dramatization of some of the ethical

dilemmas faced by family members and healthcare professionals. The book has a variety of

characters ranging from doctors, patients, nurses, nurse aids, children, parents, family members

and relatives of patients among other people. The book lacks a central character; however,

Patrick Dismuke qualifies to be the central character because most of the events in the story

revolve around him. The book is chronologically structure over a six months period that starts

from May and ends in October. The setting of the book is in Hermann Hospital in Houston,

Texas, and thus the main characters are either the employees, the patients at the hospital or the

family relatives. The book is divided into six parts, each part, there is a character facing a

particular dilemma, some characters are recurrent through the book.

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The book is very effective in offering an in-depth look towards the decisions made during

provision of services. Healthcare professionals face significant challenges when providing care

to people. Lisa Belkin has done her best in giving the audience a glimpse of how the decisions

are made as well as how the involved parties feel when making the decision. For example, in the

case of Patrick, a fifteen-year-old boy suffering from a chronic, incurable disorder of the

digestive tract, “Patrick was born with Hirschsprung’s disease, a disorder of the digestive tract,

and after years of surgery to snip out parts of his intestine, he was left unable to digest his food”

(Belkin, 2021);and Armando, who had a bullet in his brain consequently leading to paralysis

from the neck downwards, the committee of the hospital was at crossroads when making

decisions that would affect the lives of these patients. Similarly, the family members were at a

point of dilemma. There is no happy ending, Patrick dies and Armando survives, and that is what

happens in hospitals, in a point of ethical dilemma, sometimes the decisions made save the life

and sometimes, the patient dies.

Comparing the events in the book to those that have happened in 2020, there is a number

of similarities. In the book, the healthcare professionals are faced with the challenge of deciding

when to withdraw life support. Similarly, in 2020, the world was at a point where life support

equipment was significantly needed due to the covid-19 pandemic. It went to a point that

hospitals had to borrow equipment from senior care facilities or to decide whether or not to

withdraw life support from patients who had been on support for a long time. This therefore

shows that ethical dilemmas in healthcare persist, some are the same, the difference is the setting.

In conclusion, healthcare professionals face ethical dilemmas every day. Sometimes,

there is a happy ending whereby the patients survive and in other circumstances, the patient dies.

All these, are normal situations in the healthcare setting. As healthcare professionals, nurses are

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not supposed to harm the patient, however, in certain circumstances, even when no harm

happens, the patient dies. In hospitals, there is no happy or sad ending, all that matters is that as a

healthcare professional, one should do their best to ensure the wellbeing of their patient.

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Reference

Belkin, L. (2021). First, Do No Harm: The Dramatic Story of Real Doctors and Patients Making

Impossible Choices at a Big-City Hospital. Simon and Schuster.