Should healthcare professionals sometimes allow harm? The case of self-injury.

This paper considers the ethical justification for the use of harm minimisation approaches with individuals who self-injure. While the general issues concerning harm minimisation have been widely debated, there has been only limited consideration of the ethical issues raised by allowing people to continue injuring themselves as part of an agreed therapeutic programme. I will argue that harm minimisation should be supported on the basis that it results in an overall reduction in harm when compared with more traditional ways of dealing with self-injurious behaviour. It will be argued that this is an example of a situation where healthcare professionals sometimes have a moral obligation to allow harm to come to their patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.