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Antoni Trilla, MD; Teresa Faura, RN
Hospital Clinic of Barcelona Barcelona, Spain

JAMA. 1995;274(6):460.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In an excellent article published recently in JAMA, Dr Leape¹ discusses the mechanisms and some models of medical errors. In his initial statement, however, a historical error is introduced. Florence Nightingale must take credit for many important contributions to the progress of medicine and nursing, but certainly not for being the original author of the dictum, "first, do no harm."

Since the time of Hippocrates (circa 500 BC), the principle of "primum non nocere" ("the first thing [is] to do no harm" or "above all, do no harm") has been quoted by medical writers with respect and considered "medicine's most cherished principle."² It has been taught this way to every medical and nursing student throughout the world and through the years. However, even the real meaning and logic of this principle has been questioned recently in an excellent review by Brewin,³ suggesting that it . . . [Full Text PDF of this Article]

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