‘Primum Non Nocere’ in Skepticism

by | Nov 10, 2022 | Benjamin Radford, Critical Thinking, Investigation, Media Literacy, News, Psychology, Research, Skepticism | 0 comments

About two years ago, around the start of the COVID pandemic, I was looking at a friend’s Facebook page answering her question about how best to protect herself. At the time, masking was just coming to the fore but social distancing was advised and hand sanitizers were in short supply. The question was about homemade sanitizers, and—having researched the topic for the Center for Inquiry’s Coronavirus Resources Page—I suggested that it should contain at least 60% alcohol, and ideally 70%. 

Almost immediately a friend of hers posted a reply: “Unfortunately, alcohol doesn’t kill viruses. You’re better off avoiding crowds and washing your hands.” I was pretty sure that isopropyl alcohol does indeed kill many viruses (as does direct sunlight) because it literally breaks their membranes apart. It’s not 100% effective against all viruses and can only be used topically, of course, but the bold, seemingly factual statement was completely false. I spend enough of my time correcting misinformation on the internet as it is, but I realized that this comment, which could be seen by hundreds of people, had the very real potential to cause harm. I assumed that the person made a sincere mistake and was not intentionally misleading our mutual friend about how to protect herself and her family from a potentially deadly disease, but I was surprised at how self-confident, caveat-free, and authoritative it seemed to be.

I replied with a link to a reputable medical website and countered, “This is false. Alcohol does kill viruses, including COVID.” I didn’t press the matter, but thought more about it later, and the importance of invoking the fundamental medical principle of Primum non nocere, or First, do no harm.

Versions of it can be traced to the Hippocratic Oath, though in his 2005 article in the Journal of Clinical Pharmacology, Dr. Cedric Smith notes that the phrase “was in use in England and America at least by 1860. Moreover, it was transmitted relatively broadly and fairly widely by the early 1900s. The communication and transmission appear to have been largely oral inasmuch as it was not commonly seen in print until after the 1930 to 1950 time period.” Though, as Smith notes, the dictum is only one part of an ethical approach to medicine, it is nevertheless a useful starting point, “a crystallized bit of wisdom, and like many proverbs, this maxim has several levels of meaning and can be applied to a wide variety of situations.”

Though most often applied in medical contexts, its principle is sound in all areas of endeavor, including skepticism and media literacy. In fact I first encountered it in a professional setting when I became managing editor of Skeptical Inquirer magazine nearly 25 years ago. Part of my duties involved copyediting—the often-mundane but sometimes fun job of ensuring consistency, author correspondence, correcting grammatical errors, minor fact-checking, and other duties.

Ideally, the editor corrects mistakes, improves the writer’s flow and organization, and so on. The next best thing is to make changes, such as synonymous rephrasings, that may or may not subjectively improve the piece, but don’t substantively change the content (an example might be changing “pissed off” to “irritated”). Moving down the ladder, missing mistakes is minor (though inevitable); few books, newspapers, or magazines hit print with all mistakes caught and corrected.

But the worst thing you can do—the cardinal sin in copyediting—is to introduce an error into an article. It’s one thing to miss writers’ mistakes, but a very different thing to actively make a change or addition that is wrong. Your copyediting should improve the work, or at least keep it about as good as when you got it, but you damn sure better not make it worse. Hence: First, do no harm.

In principle, of course, it’s often clear-cut but murkier in practice. Two brief examples, also drawn from social media experience, may help illustrate my point. Recently a colleague posted a comment referencing mental illness in the context of the recent Uvalde school shooting. It didn’t directly blame mass shootings on mental illness, but it did imply a link between the two. Having recently written about the demographics of mass shooters, I knew that—contrary to popular opinion—people suffering from mental illness were in fact less likely to be violent than others, and far more likely to be victims of violence.

My friend’s post, though well-intended, without much mental gymnastics could easily have given the impression that he (like the conservative politicians he was criticizing) was assuming or advocating a link between being mentally ill and being a mass shooter. When I—rather diplomatically, I thought—suggested that the phrasing might be problematic and that we (as skeptics and critical thinkers) should be careful about making such faulty links, I got some pushback. Others agreed with me, and he (admirably if somewhat reluctantly) updated the post to clarify. Like the previous poster about alcohol and viruses, he was surely trying to be helpful and provide a useful information and perspective.

A second example is perhaps a bit more complicated but worth an analysis. Many liberal and progressive people in my social media circles have shared cartoons and memes about Critical Race Theory, often in the context of mocking the (real or feigned) conservative outrage about it. One example is below.


The problem with this image, and others like it, is that it fuels and legitimizes the conservative mistake that Critical Race Theory (CRT) is being taught in public schools as history. Despite what Fox News says, CRT is neither taught in schools nor as history; it has occasionally been taught in law schools as part of legal analysis. The cartoonist accepts that premise as the basis for the joke, explicitly equating teaching CRT with teaching history in public schools. The joke being made is not that conservatives are wrong about CRT being taught in public schools (which they are), but instead that they’re hypocritical by objecting to one and not the other. I’ve seen countless progressives sharing this, not realizing they’re just adding to the misinformation and reinforcing the very conservative views they’re mocking.

Critical Race Theory is not history, and has never been taught as history; it is instead a legal theory, which—like all legal theories—is in turn based on history and precedent. This is neither a criticism nor defense of CRT, merely a clarification. As with the other examples, while the message is well-intentioned, the underlying premise is not only false but counterproductive and potentially harmful. By stipulating to the (demonstrably flawed) premise that CRT is being taught to children in public schools, progressives who create and share this are simply adding to the misinformation. For more on how advocate and activist efforts can backfire, see my new book America the Fearful: Media and the Marketing of National Panics.

Practicing Primum non nocere

Of course, not everyone on social media cares about whether the information they post is strictly factual. Many just post to be provocative or share memes that generally align with their political views, regardless of whether the specifics they contain are true. However people curate their page, choosing what material and views to post and share is their business, but there is reason for concern.

Doctors, of course, are held to higher professional, ethical, and legal standards than university professors or academics—and for good reason: the “doing harm” bit in that context is potentially lethal. But there is a sense in which skeptics and educators—if not social media denizens more broadly—should also strive to adopt the Primum non nocere principle.For those of us who work in the field teaching critical thinking, skepticism, or media literacy for example, we might hold ourselves to a higher standard. As people who have honed our critical thinking skills, we are (or should be) better equipped to recognize misinformation and, on the whole, present and share a higher caliber of material.

We like to think that our writing and intent is crystal clear (as a writer, I can assure you it’s not; as Andrei Tarkovsky wrote—inspiring a Shriekback album—“A book read by a thousand different people is a thousand different books”). Eloquent phrasing that seems clear in the context of our thoughts and assumptions loses much when posted to social media or fixed on the page. As with spotting logical fallacies, the principle of confirmation bias is strong in all of us; it’s easier to spot errors by those we disagree with, but much harder—and more valuable—to catch our own mistakes (ideally before they’re spoken or typed). We all hold some false beliefs, and we all, at some point or other, make those beliefs public.

Everyone makes mistakes, and the point it not to police speech but to sow a gentle reminder to think twice. On one level it might be recast as “If you aren’t sure you’re saying something both true and helpful, don’t say it.” Another, admittedly somewhat fraught, refinement might be, “If what you’re saying could be, or is likely to be, misunderstood and therefore mislead, rephrase it or don’t share it.”

The best thing one can do with a comment or thought is to improve the world, adding useful information and perspective to help others understand a topic. The next best thing is to listen or read without comment, absorbing and analyzing information and views of others. The worst thing is to comment and share false information that may mislead or harm people. No one can be expected to fact-check everything they write or share, but it’s our obligation to help mitigate rumors and misinformation. Beliefs have consequences, so when you post, please First, do no harm.


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