What is a Principle?
Probably the most common use, the sense in which the word “principle” is most familiar, is related to moral principles. We think of a principle as a rule of action, a standard by which to measure or judge things. There is a certain generality about principles. Principles will often underlie actions and relate to the quality of the action performed.
“Principle” according to the Latin derivation and the equivalent Greek root means “a beginning or a foundation”. We may speak of a first principle in that it comes before everything else.
In any systematic discipline there are fundamental principles. We have frequently spoken about these in Hygiene. One of the fundamental principles of Hygiene states that “there should always be a normal relationship between the living body and the materials, agents and influences that provide its needs”. For example, there is a normal relationship between food and the living organism. Food is useable material. It can be broken down into its constituent nutrients, which, in turn, are oxidized to provide energy or reconstituted into living tissue, or biochemical products utilised in the performance of the body’s functions.
Conversely there is no normal relationship between alcohol and the living body. Alcohol is classified as a protoplasmic poison, that means it is poisonous to all forms of life. We are all well aware of how dramatically it affects mental and physical performance. So, as a general principle, it is undesirable to take alcohol.
Now the question arises about the use of drugs. Drugs are poisons; that is why their use is restricted. They can only be prescribed by licensed physicians. They can only be dispensed by licensed pharmacists; their poisonous qualities are well recognised, they have no normal relation to the body. Taking drugs violates this fundamental principle. So how do we resolve this conflict?
The general principle is true. So far as we are able we should only consume and expose ourselves to those materials and influences which have a normal relationship to us. However, we all know that life requires compromise. We all know that we do not live in a perfect world and that there are times when this principle has to be violated, no question about it. If a person is involved in an extremely serious accident and sustains life threatening injuries intervention is necessary. If surgery has to be performed, it is absolutely essential that anaesthetics be used and drugs are justified in the care of the patient. Certainly the drugs will have effects that we do not want; certainly we are using agents that do not have a normal relationship to the body and are, in fact, injurious.
The choice we have is a dilemma, the choice between two undesirable alternatives. We know that it is not desirable to receive an electric shock, that this certainly does not have any normal relationship to the body and one should avoid it. But if we consider a patient in cardiac arrest, and cardio version (defibrillation) is proposed, we know that if the patient is left, death is imminent within a few minutes and preceded by irreversible brain damage. Something must be done and quickly. The patient is given cardio version, the heart starts and for the moment, the patient’s life is saved. It is a violation of this fundamental principle. It is a necessary compromise. I think it is sheer stupidity to argue otherwise. A person may say, this is the principle, I am going to live by it, I will not compromise. That is fine; one hopes that the person is never placed in a position where they have to make a choice because these decisions have to be made somewhere everyday.
Taking drugs is certainly not something that the Hygienist recommends or even condones. Most of us would go to extreme lengths to avoid it. The majority of uses of drugs are unnecessary, unjustifiable and dangerous and there are better ways of dealing with the problem. However, there are situations where their employment is vital to the life and recovery of the patient. The drug will still do harm. This does not invalidate the principle. This does not mean that we can justify every prescription that is written and every medicament that is dispensed, not at all. Drugs should be employed rarely and only under special circumstances where intervention is fully justified. Eurooppalainen nettiruletti Verkossa. Pelata Eurooppalainen ruletti.