4 min read

Why we should adopt the Hippocratic Oath as the first rule of philanthropy.

That the Hippocratic Oath is cast in the negative (“do no harm”) tells us something essential about human affairs.

As well intentioned as we might be, our actions produce effects the consequences of which we can’t begin to divine. The Oath reflects the tendency of human beings to forge ahead into this unknown, to believe they have answers when they don’t, and to be blind to their own impulses. Each of us inclines to the belief that we are good persons, and from such sources only good things can come.

The Oath, on the other hand, connects to the conviction that “from the crooked timber of humanity, no straight thing was ever made.” Where others call for action, it invites caution; where others emit self-confidence, it counsels self-doubt; where others assert conviction, it asseverates humility.

The “crooked timber” school is out of vogue in no small part because it seems to retard progress where it meets her and prevent healing where it is most needed. It also conflicts with the therapeutic impulse of our age, which insists that we have a fundamental right to always feel good about ourselves.

The medical model has become a predominant metaphor of our politics.

Social life is seen as beset by “pathologies” which require “cures” administered by experts. We cast things in terms of “problems” and “solutions,” with the assumption that everything that goes wrong has a cause which is clear and definable. If the exact agent can’t be identified, the cause is called “systemic.” Social reformers are essentially epidemiologists who provide targeted cures where both agency and victimhood is clear, and systemic cures where it is not. Once they alter the scale of their concerns, they will engage in aggregation of populations, collection of data, and large systemic responses. Such projects can in the nature of the thing only be accomplished by therapists who possess large amounts of capital and technical control.

Thus, it is not surprising that much of what passes for “philanthrocapitalism” can be found in Silicon Valley, where venture capitalism, data collection, and technical wizardry intersect. It is also where the schemes of world-improvement operate on the most broadly systemic level, make the most audacious claims about what can be accomplished, and actively squeeze out competing authorities.

Author and journalist Anand Giridharadas identified this tendency in his Winner Take All: The Elite Charade of Changing the World.

Giridharadas describes how philanthrocapitalists, particularly those who have struck it rich in the tech sector, consolidate wealth, power, and authority, while at the same time try to present themselves as the benefactors of mankind. The lie is in part given away when they admit they won’t let their own children use the technology they are selling to everyone else, and from which they have amassed immense fortunes.

There is perhaps no better example of this phenomenon than Mark Zuckerberg, whose business model disguises itself as a “community” that seeks to do good and to shape the electoral practices of our democracy. As Giridharadas points out, if any other institution, especially banks, were to insert themselves so thoroughly into the practices of our democracy, they would be condemned by the public and politicians alike.

Zuckerberg gets away with it in part because of the fig leaf of philanthropy he has placed over his business model, in part because his wealth makes politicians take him more (and in some instances less) seriously than they ought, and because he has put together a consumer product that taps into and exacerbates the alienation that is so prevalent in American society. In other words, the tech industries act like doctors guilty of the malpractice from prescribing an universal narcotic that is also the disease.

Giridharadas exposes the leadership class as hiding behind “win-win” language that obscures the “win-lose” reality of competitive economics.

One interesting part of this centers on the people with whom these elites try to create “win-win” relationships. But the word “relationship” deceives, for the emphasis on systems and “problems” bypasses the need to engage in relationships, and the emphasis on data collection and metrics enables them to demonstrate their “effectiveness” without having to deal with the messy reality of interactions with other persons.

Much of this hinges, therefore, on an assessment of what the problems actually are.

Were one to suggest, for example, that loneliness and alienation are among our biggest problems, the complicity of the tech companies might be so apparent that even they couldn’t avoid noticing it. And loneliness is not a “problem” that is easily “solved,” and admits of no monetary solution. One essential factor in exacerbating loneliness has been the reconfiguration of the scale of life, to which crony capitalism, bureaucratic centralization, and technological efficiency have been central contributors. As Giridharadas says: the master’s tools will never be used to dismantle the master’s house.

I return to where I started: the recommendation that the first rule of philanthropy, economics, and politics ought always to be “First, do no harm.”

Where there is an external (not internal) compulsion to act, and one has the proper authority to do so, and the requisite skills, then one should act, but cautiously and humbly.

One way to insure this humility is by concealing the act.

 A second way is by recognizing and endorsing the authority of those whose agency is being affected, rather than co-opting their authority and using it to increase your own.

Third, one must always be on guard against situations where the cure is worse than the disease.

And, finally, one must begin by acknowledging that not everything that happens in this world is a problem that needs to be solved. Sometimes, a disease just needs to run its course before the patient recovers.

2 thoughts on “First, do no harm”

Leave a Reply

Your email address will not be published. Required fields are marked *