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Harm is a central concept both in the practice of medicine and in ethics. Hence, it is no surprise that in bioethics harm plays a prominent role. The proper goal of medicine is to prevent, alleviate, or eliminate harm to patients that result from disease or injury. Moreover, some medical interventions themselves have a serious potential to cause additional (iatrogenic) harm—for instance, pharmacological side effects or even death from surgery.

General prohibitions against inflicting harm on others supposedly belong to the principles of any moral code, and an attitude of non-malevolence (taking care that others do not suffer harm) is widely regarded as a core virtue and as a decisive source of moral motivation. Beyond this, bioethics is concerned with harm-related judgments, obligations, prohibitions, and problems. The harm at stake is most often harm to patients. Such debates as those about professional duties toward patients, about matters of resource allocation, or about the limits of patient self-determination all deal in part with actual or potential suffering, dysfunction, pain, or death of patients. Some problems, however, relate to potential harm to third parties. For example, HIV-positive patients risk infecting uninformed sexual partners and pregnant women who consume drugs risk harm to their unborn children. Other ethical questions deal with harm to health professionals themselves—when, for instance, a physician faces treating a contagious patient under substantial personal risk. And finally, various arguments in bioethics address the possibility of long-term social harm resulting from certain permissive practices (the so-called slippery slope argument). For example, critics of prenatal selection against severe genetic diseases predict shrinking social solidarity with the handicapped and with their justified claims to social support.

While its central role in bioethics thus cannot be disputed, harm remains a vague and contested concept that in and of itself does not provide much moral guidance. What counts as harm varies greatly, as do the scope and relative importance of the prescriptions not to inflict, to prevent, or to remove harm.

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