Above all, we surely agree, as physicians we must endeavor to do no harm. This is encapsulated in the most venerated maxim of medical ethics: first, do no harm—primum non nocere. However, despite the ubiquity of this saying within our profession, to many bioethicists, “first, do no harm” is little more than a pithy aphorism.1,2 “To observe this advice literally is to deny important therapy to everyone,” Louis Lasagna wryly observed, “since only inert nostrums can be guaranteed to do no harm.”3 Shelton1 wrote satirically about a group of medical students who propose some treatment on rounds and, when told the maxim in response, feel “awed by the wisdom and nobleness of his or her chosen profession” but remain clueless about how to actually treat their patient. The American Academy of Pediatrics Committee on Bioethics has circumvented ambiguity about the exact meaning of the phrase by omitting it from its position statements altogether.