PRIMUM NON NOCERE is a principle to which medical students are introduced early in their careers and of which they are, or ought to be, reminded throughout their clinical training. It is the principle that reminds us that, in attempting to treat our patients, we should first aim to avoid making their conditions worse. To the extent that clinical practice is guided by well-researched, scientifically validated treatments that are safe and effective, adherence to primum non nocere may be relatively easy. In contrast, many clinical situations are fraught with diagnostic uncertainty. Also, treatment options may not yet have been adequately researched and found safe and effective. In these situations, adherence to primum non nocere requires the application of cautious, thoughtful clinical judgment based on whatever information is available. The practice of prescribing psychotropic medications to young children is just such a situation and is addressed in the report by DeBar et al in this month's issue of ARCHIVES.1
Barbaresi WJ. Use of Psychotropic Medications in Young, Preschool Children: Primum Non Nocere. Arch Pediatr Adolesc Med. 2003;157(2):121–123. doi:10.1001/archpedi.157.2.121
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