First, Do No Harm

Hippocrates

This phrase – First, do no harm – is a translation of the Latin Primum non nocere and is often thought to be part of the medical Hippocratic Oath. The phrase does not appear explicitly in the Hippocratic Oath. The Greek philosopher and physician, Hippocrates, writing in the 5^th – 4^th centuries BCE did include phrases that come close to the famous phrase. In his collection of works he exhorted physicians to ‘do good, or to do no harm.’ In early versions of the Hippocratic Oath he asked the physician to promise ‘to abstain from doing harm.’

While the precise source of the phrase, First, do no harm, is lost to history, students of bioethics will recognise it as a fundamental principle found throughout the world.

Although the phrase is primarily found in bioethics and perhaps hanging on the wall of your family doctor, the phrase could be applied to other areas of our lives, especially to environmental ethics.

If there is a primary and essential principle in how we behave towards the environment, that principle should be First, do no harm.

Sadly, it doesn’t seem to be applied. Two possible, inter-locking, reasons for this might be the following:

1. Much environmental harm takes place far from our gaze, so that the harm is out-of-sight and out-of-mind.
2. Our cultural conditioning tries to steer us clear of uncomfortable images and experiences, so that we often do not look beyond our immediate comfort and convenience.

The author and cultural critic, Vanessa Machado de Oliviera, summarises this second reason explicitly in her outstanding book, Hospicing Modernity. She writes that, ‘Modernity conditions us to … gravitate toward what validates our ego-logical desires for the 6 “Cs” of comfort, convenience, consumption, certainty, control, and coherence.’¹

When environmental harms are out-of-sight, out-of-mind then our ego-logical desires are satisfied and we do not have to face discomfort.

Perhaps two examples will help to clarify these ideas. The first example is straight-forward and the harm is out-of-sight after the product has been used. The second example is controversial and the harm is out-of-sight before the product is used.

Example 1: Plastic pollution. We all know that non-recycled plastic harms the environment. A lot of this plastic ends up in the oceans – out-of-sight, out-of-mind. Around 11-12 million tonnes of plastic end up in our oceans every year and the amount is growing. That’s approximately 2,000 garbage truckloads per day! Most of it is single-use packaging, abandoned fishing gear, or synthetic textiles.

One of the regions where a lot of plastic ends up is in what is known as the Great Pacific Garbage Patch, an area in the middle of the Pacific Ocean roughly twice the size of Texas, containing 1.8 trillion² pieces of plastic.

Plastic pollution is an ever-increasing problem. In 1950 about 2 million tonnes of plastic was produced. Nowadays more than 450 million tonnes are produced annually, and growing. In the first two decades of this century the amount of plastic produced per year more than doubled.

We use plastic for our convenience and comfort (as Machado notes) and then when finished with it is discarded and the harm to the oceans occurs away from our gaze.

Example 2: Electric Vehicles (EVs). This example is more controversial because many (even within the environmental movement) promote EVs as one of ways in which carbon dioxide emissions can be reduced, thus helping to “solve” the climate crisis.

However, the climate crisis is not the environmental crisis. Climate change is a symptom of the much broader environmental crisis. The production of EVs require the mining of rare earths and other elements, such as lithium and cobalt. The mining of these takes place well away from the gaze of those purchasing EVs.

Although out-of-sight and out-of-mind, the mining of these elements does major harm to the ecosystems in which the mines are located. Admittedly, the harm done on a world-wide scale may not be as significant as the harm wrought by carbon emissions.

But, that is not the point. The harm done to local ecosystems can be significant, and often is. The harm perpetuated is out-of-sight and out-of-mind and thus does not disturb our westernised comfort and/or convenience.

Just one of those elements – lithium – is mined mostly in sensitive ecosystems and on or near the lands of indigenous people.

The production of one tonne of lithium (enough for 100 batteries) requires approximately 2 million litres of water – water that is crucial to the ecosystem that it is extracted from. Chile holds more than 50% of the world’s deposits of lithium has seen up to 65% of the region’s water used for lithium extraction.

Zulema Mancilla, a member of an indigenous community living in northern Chile has been opposing lithium mining in the area and says that ‘We have serious problems with water’ because of mining companies. She goes on to say, ‘We will never be happy about people coming to pollute and extract the natural resources of our territory.’³

If flamingos could speak to us, they would no doubt concur with Mancilla. A 2022 study found that flamingos were slowly dying as a result of lithium mining in Chile.⁴

Whether in Chile, or elsewhere in the Lithium Triangle, or in the Australian outback, or Thacker Pass in Nevada, the extraction of lithium does immense harm to the flora and fauna of ecosystems, and greatly disrupts indigenous communities.

But, this harm is out-of-sight and out-of-mind.

Tragically too, the production of EVs has not decreased the amount of carbon emissions in the private vehicle sector. The only event to reduce emissions came in the form of the coronavirus, but following that emissions bounced back quickly, and are now at higher levels than before the pandemic.

The principle of First do no harm is not being applied.

If we truly do want to first do no harm, then we must cast our gaze much wider so that we are looking at what is out-of-sight. Plus, we must overcome our westernised, Euro-centric, desires for convenience and comfort. Other communities (both human and non-human) suffer harm because of these desires.

Notes:

1. Vanessa Machado de Oliveira, Hospicing Modernity, North Atlantic Books, Berkeley, California, 2021

2. A trillion is 1,000 billion. Thus 1.8 trillion pieces is 1,800,000,000,000 pieces.

3. https://www.ohchr.org/en/stories/2026/02/resisting-age-lithium-right-healthy-environment-indigenous-territories-chile  accessed 18 March 2026

4. https://royalsocietypublishing.org/rspb/article/289/1970/20212388/79366/Climate-change-and-lithium-mining-influence  accessed 18 March 2026