When Medicine Abandoned ‘Do No Harm’

Written by Hart on February 2, 2026. Posted in Current News

The principles that once guided doctors have died and we need to resurrect them. Over the past few years, something profound has shifted.

Quietly and without much public debate, the principles that once protected patients have been dismantled. In this video, I want to trace how that happened chronologically and show why it matters not just to doctors, but to every one of us. Medical ethics was built on a simple foundation.

A doctor has a duty of care to the individual in front of them. And of course, the most often recited line is, first, do no harm. This notion forms a cornerstone of trust between doctor and patient. Being able to trust that your doctor has your best interests at heart is especially important when doctors are not independent, but are employed by the state. In recent years, these principles have been eroded to the point of total destruction.

The timeline of this ethical collapse is remarkably short. Let’s go back to the 1970s and the smallpox vaccine, which was discontinued in the UK and across Western Europe. At the time, the disease was still active in large parts of Africa, Asia and South America, but it wasn’t really a threat anymore in Europe. The smallpox vaccine carried real risks.

It was especially risky in children with eczema or suppressed immune systems but there were also life-threatening complications like encephalitis or inflammation of the brain. Doctors recognized it was not acceptable to put perfectly healthy children at risk in this way, even though smallpox had not been eradicated globally and even though it might have had a 10 % mortality rate, so the vaccine was withdrawn. And that’s standard, that any intervention in a healthy child must be properly safe, held for decades afterwards.

As recently as 2012, the World Health Organization made this point explicitly in their guidance on vaccines, they stated, since vaccine recipients are generally healthy, there is a lower level of tolerance for the risk of a side effect as compared to medications. Vaccines are given to children. The tolerance to risk is lower still. Thus, a much higher standard of safety is expected of vaccines.

Now, a new version of this guidance was produced in 2021 based on decisions taken in 2019 and they removed those words from the guidance. So the long-held ethical principle of first do no harm had been quietly abandoned when it came to vaccines. The consequences of scrubbing this basic principle from the guidelines soon became very real.

In February of 2020, a BMJ article examined the WHO rollout of the malaria vaccine, MoscaX. There’d been a large trial which showed that the vaccine reduced cases of severe malaria by 29%. Now, statistically, that meant nine cases were prevented in a thousand children over four years. However, in the cohort of vaccinated girls, the risk of dying from any cause doubled.

The trial found 11 more deaths per thousand girls in that vaccinated group. Now, the entire purpose of conducting clinical trials is to detect differences in morbidity and mortality. And if a trial reveals that an intervention doubles the death rate and that finding is ignored, Why are we doing trials at all? But that’s exactly what happened.

Despite the doubling of deaths in the female cohort, muskwicks was introduced across parts of Africa in what the WHO described as a pilot introduction. They justified this, stating the benefits outweigh the risks. But this simply is not true when looking at the most serious risk of all, death.

Recipients were not properly informed of this potential risk before being injected. In order to be properly informed, the parents of any girl taking part in this pilot scheme would have to be told that by taking part, their daughter’s statistical chance of dying over the next four years would double. Who in their right mind would agree to this roll of the dice?

To visualize it better, imagine a wheel of fortune with 1,000 segments. Nine of those segments are green and they represent children spared a severe case of malaria compared to the control group. It should be noted that severe malaria doesn’t necessarily mean death. 11 of those 1000 segments are red and those represent an extra 11 children who died in the vaccine group compared to the control group in that four year period.

Now, as always, there is uncertainty, but the trial was big enough to show that the number would be between four and 19 extra deaths. Would you take a spin on that wheel for your perfectly healthy child?

No one explained these odds to the families involved. Children were sacrificed to potentially benefit other children without consent. This represents a fundamental break with the ethics that once governed medicine. And the shifter can also be heard even in the language that’s being used.

So we used to frequently hear “doctor-patient relationship” and “trust”, but now increasingly we hear technocratic and impersonal words like “benefit risk profile”, “target population” and “acceptable risk at a population level”. Individual tragedies have been reduced to data points in spreadsheets, but in reality these data points are actual children whose lives were sacrificed for the statistical greater good.

This marked the move from a system that ensured individuals are not harmed to a utilitarian calculation in which some lives are expendable. Even within that highly unethical framework, this particular vaccine did not pass muster. It was a statistical failure and yet was still rolled out.

Now the policymakers do not see the faces of those harmed, nor do they stand in front of the parents who needlessly lost their child and they will never be held to account for that. It should not really need stating that a healthy child has no moral duty to risk their health or their life for the sake of another child, however vulnerable. When that is imposed as an obligation, trust understandably collapses.

The often cited risk benefit analysis is very different when talking about a sick person compared with intervening in the life of someone who is perfectly healthy. When you’re sick, doing nothing has a potential cost. Without treatment, the illness may get worse. So an intervention has the possibility of significant benefit, even if it comes with a risk.

Now, this is a world away from a perfectly healthy person being asked to take on risk for a disease that in all likelihood will not come to pass for them. When focused on healthy individuals, if the illness is rare or mild and the intervention carries even a small chance of serious harm, the justification disappears entirely. That used to be understood as basic common sense and good ethical practice.

That was the boundary medicine refused to cross. And that was the basis for the 2012 WHO statement. By the time COVID vaccines arrived, that boundary had been erased. Why?

What was the motivation for the removal of that protection? Decisions were no longer being made for individuals, but for populations. Suddenly, vaccines were being rolled out to people who could not possibly benefit. Even when known risks had been measured and recorded, and well before harder to measure risks over a longer timeline had been properly assessed. Patients were not properly informed and so could not possibly give their consent. Both benefit and risk became collective with calculations done on a population level rather than with the individual in mind.

Even if the strategy had worked, it would have been unethical. In the end, the strategy failed in every imaginable way and there have been a broad range of harms that are still being tallied. Is it any wonder that trust in the NHS has fallen to an all-time low? This new ethic of collective good and sacrifice was articulated and defended so much that people adopted it as if it was justified.

This was laid bare in a headline written by Tom Chivers in the publication Unherd in January 2022. said,

“Is it worth vaccinating children? It sounds cruel, but a small number of deaths would be worth it.”

One wonders if Chivers has children and whether his child’s death would be worth it for the greater good. The suggestion that some must be harmed, children no less, so that others might benefit was being defended.

Once the ideal of the sacredness of the individual has been lost, how does one weigh up the value of a life? Neurosurgeon Henry Marsh was clearly caught up in this thinking when he said,

“even if a few grannies get bullied into assisted dying, isn’t that a price worth paying?”

Would he happily see his own mother be one of the bullied grannies, I wonder? He later said this.

“I know I made a very crass comment about sacrificing grannies. I greatly regret it. I wish I hadn’t said it. I didn’t want to say it. I was very stupid. I didn’t realize I was going to get in public domain. But the principle is there is always a cost.

Every time I operated and it was not a theoretical risk, you can make things worse. But you justify that risk by saying more people benefit. It sounds rather inhumane and utilitarian, but that is the reality of normal medical practice.”

It appears that what he regretted most was the fact the comment found its way into the public domain, not the fact he had expressed the argument in the first place. Now, in surgery, patients accept risk in the hope of personal benefit if the risk plays out.

It was part of a choice they made because the potential benefit to them personally was worth that risk. What Marsh described was something else, a system in which harm is inflicted on a person, a person who never consented to fulfill the preferences of another. The person who lost their life was an innocent bystander and they did not choose it. Someone else chose to end their life. Who awarded them this right? This is the logic that now guides public health from the malaria vaccine rollout to COVID mandates to assisted dying.

The pattern, or rather the slippery slope, is the same. The individual has been replaced by the collective. The principle of consent has been subordinated to the needs of the majority. Such a set-up requires doctors to be loyal to the system over their patient. Patients are then simply unprotected data points. It took just six years to overturn centuries of medical ethics.

No one has acknowledged it. It must be acknowledged, apologised for, and repaired because historically the slope we have started to slide down does not have a happy ending. It is within this greater good framework that Chris Witte has now approved mandatory folic acid supplementation in all white flour, despite knowing that it will cause harm to a significant subset of the population. And it is in the same spirit that the chickenpox vaccine is now being added to the MMR schedule, fully aware that this combination will cause around one in 3,000 children to suffer a febrile seizure when having them separately does not.

Because the chance of benefit and of risk are both quite low, the chance that any child who is harmed would have been one that benefited is also very low. They are different children. In both cases, individual risk has been accepted on behalf of others, not by the patient or parent, but by a system that is treating numbers in a spreadsheet, not individuals.

If it was possible to see the entire population of children, then you would see those who might be harmed by chickenpox and you would want to do something about that. But if you then had to go and select children who would be harmed in order to prevent the chickenpox problem, you couldn’t do it. And if you can’t do it when you see their faces, then you shouldn’t do it just because their numbers in a spreadsheet. Those harmed are seen as statistical inevitabilities, tolerated sacrifices for the greater good.

Until the duty to protect the individual is restored to the center of every medical decision, there can be no return to trust. Medicine cannot possibly call itself ethical while knowingly risking harm to the few in pursuit of alleged outcomes for the many. People speak of protecting minorities, but the smallest minority and the one most easily ignored and arguably the most vulnerable is the individual.

Civilizations that build their ethics around collective outcomes must eventually decide whom they are willing to harm and who gets to decide. That is not a path we can drift down with our eyes shut. We must acknowledge the path we are on and purposefully walk away from it.

Societies that base their ethics and collectivist utilitarian ideologies are societies based on human sacrifice with those in power playing God, but medicine is not God. It does not have the right to decide who may be harmed for the sake of others, no institution or its employees should be making those choices.

We do not protect society by sacrificing its people. We protect society by protecting each person within it.

source  hartuk.substack.com

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