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Should healthcare professionals sometimes allow harm? The case of self-injury
  1. Patrick J Sullivan
  1. School of Law, University of Manchester, Manchester, UK
  1. Correspondence to Patrick Sullivan, The Centre For Social Ethics and Policy, School of Law, University of Manchester, Williamson Building, Oxford Road, Manchester, M13 9PL, UK; Patrick.sullivan-2{at}


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.

  • Autonomy
  • Clinical Ethics
  • Psychiatry
  • Paternalism
  • Coercion

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.