A few years back, I was having a chat with my auto mechanic, an old family friend. He was lamenting the difficulty in finding good help (a common complaint and issue for anyone who employs people), noting that so many “experienced” mechanics are simply, as he called them, “parts changers.” Given that I’ve done my share of automotive maintenance over the years, the meaning of his lament immediately clicked in my head: their approach to an automotive issue was to start swapping parts and see if the problem got resolved, rather than using their brains to attempt a diagnosis before acting. It’s also a common approach that many backyard mechanics take, especially if they’re still relatively new to DIY auto repair. While there’s skill involved, it’s a rote sort of skill instead of an application of brainpower, care and consideration, and reflects a shallow and unthinking approach to problem solving.
This, of course, costs the customer time and money and costs the shop reputation. It’s not a harmless approach, but instead a wasteful and inconsiderate one that has long-term negative effects.
A core principle of bioethics and medicine is primum non nocere, which translates to “first, do no harm.” We might conclude that, in holding this principle paramount, the world of health care recognizes that diagnoses and prescribed treatments are not always certain or sure-fire, and caution and discretion are placed ahead of action. Yet the parts-changer exhibits a feckless disregard for this principle. Sure, if it takes 5 parts changes to solve the problem, the car has 5 new parts in the place of older ones, but there is the opportunity cost of that spent money and the wealth lost by removing 4 functional parts from the car. Frederic Bastiat has a brilliant treatise, That Which Is Seen, and That Which Is Not Seen, (more commonly known as The Broken Window) that explains how wealth is lost and harm is done when something of value is broken or discarded.
Yet in so many things that government does, we see the same callous indifference regarding primum non nocere and the destruction of wealth. Make-work jobs programs, initiatives that, despite failing to work as intended, continue to get funded, bridges to nowhere, health care reform, knee-jerk attempts at gun control, welfare programs, extensions of unemployment benefits, billions in foreign aid, military interventions, picking sides in other nations’ internal conflicts, on and on and on and on. The standard modus operandi of government is to do something, with little regard for the not-seen adverse effects, with little consideration of opportunity cost, and with little concern for the harm done to some if there is “help” to be provided to others.
Government is also terrible at addressing its mistakes. They get acknowledged and mis-steps get fixed only when the people at the top and the parties in charge change. In today’s sound-bite, gotcha world of political press coverage, admitting error or even conceding that something didn’t work as intended and thus needs fixing can be political suicide. This is unjust, unfair, counterproductive and harmful to the nation’s well-being, but it is reality. So, bad programs continue and the damage they do is either ignored or addressed with more programs. Bandaging a knife wound without removing the knife, though, doesn’t fix things, and writing more laws to fix the damage caused by previous ones isn’t effective unless the previous laws are repealed. Doing no harm and undoing past harm don’t seem to factor into the equation.
Even when government effects change, it isn’t always in the right direction. Back when I worked in defense, I witnessed a couple leadership changes on the government side of programs I worked on. Those changes inevitably and invariably led to changes in the programs themselves – goals, focuses, specifications, etc. I learned that it was well understood that a new leader would receive blame for failures rooted in his predecessor’s decisions, but that the predecessor would receive credit for successes that the new leader helped complete. So, there was always incentive to change things, just to secure future credit and absolve oneself of undeserved future blame, and if that change wasn’t in the best interest of the program, its goals and the big picture, well, the latter weren’t as important. If politics is paramount and if politics trumps focus on results, no consideration for “do no harm” is given.
The oath of office taken by US Senators and Representatives reads as follows:
I do solemnly swear (or affirm) that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I take this obligation freely, without any mental reservation or purpose of evasion; and that I will well and faithfully discharge the duties of the office on which I am about to enter; So help me God.
The President takes a similar one:
I do solemnly swear (or affirm) that I will faithfully execute the office of President of the United States, and will to the best of my ability, preserve, protect, and defend the Constitution of the United States.
While we can have long debates about the fidelity many oath-takers have had to these oaths, lets set that aside for the moment and consider what they lack. The modern Hippocratic Oath (there are several versions) includes a healthy dose of humility, calls for ethical behavior, for acting apart from political pressures, and for recognizing one’s own limitations. In contrast, the elected official oaths demand only loyalty to the principles of the Constitution, without any mention of under what principles that loyalty should be effected.
Congressional and Presidential oaths that embrace the principle of primum non nocere in conjunction with defense and support of the Constitution might serve as a reminder to our elected officials that actions have consequences, and that they should take a bit more care when they act. Perhaps, with that gentle reminder, we might see less harm done in the name of helping.
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