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David Mills: First of all, do no harm, Mr. Trump

David Mills, Pittsburgh Post-Gazette on

Published in Op Eds

"It will kill people," an aid worker told Politico. "People will actually actually die," said another I overheard. The executive order to stop USAid and the State Department from giving out foreign aid and to stop aid workers from aiding people will do incalculable damage, even if a court suspends it, as I assume one will.

It will do great damage that does not need to be done — even, and this is the disturbing thing, to do what President Donald Trump wants done. It is pointlessly, and I would say, given his character and history, performatively, cruel.

No practical reason

There is no practical reason to stop all aid and work right away. The review Trump has ordered Secretary of State Marco Rubio to perform could be performed while aid and work continues.

As Rubio explained in his public statement on implementing the executive order, "Every dollar we spend, every program we fund, and every policy we pursue must be justified with the answer to three simple questions: Does it make America safer? Does it make America stronger? Does it make America more prosperous?"

The answers should be yes, yes, and yes, but I suspect won't be.

But the point is that the matter can be investigated while the aid the U.S. has committed itself to give and upon which people depend, continues.

Why do it the way Trump did it? People have different theories, including that he isn't actually serious and doesn't care that much, but just wants to disturb and frighten everyone in government and everyone dependent on government, to make them obey his orders. It's a management technique, and a cruel one.

Another is that he does care, because he doesn't see the point of helping people in other countries, especially those he once called (expletive)-hole countries. And that he still wants to disturb and frighten everyone for the same reason.

What does a country do with a president like that? You can agree with him 100% on foreign policy, you can be the firstiest of America firsters, and still not see the need to hurt so many people for no reason.

What should guide a president's actions, especially one who wants to change the American government as radically as Trump does? We don't really have a rule book, other than conventions of proper presidential behavior, which he doesn't accept.

The presidential guide

Every president wants to fix the country. Their voters elect them to fix the country. It always needs fixing, because a country is always to some extent broken, defective, sick. It is never what it could be. Just listen to the Trump and Biden campaign advertisements for examples of this conviction.

Someone clearly needs to do something, and our elected officials are the people deputized to do something. Within, that is, the limits of their office, which of course most of them forget. People with power tend to dislike boundaries, because boundaries keep them from doing what they want, and getting what they want.

 

That is what makes this question so important: How should they go about fixing the country, especially if they believe, as Trump does, that the country needs radical surgery? What principles should guide them? I think a parallel work gives us an idea.

Elected officials, and presidents in particular, as the head of the executive branch of government, the getting things done branch, do the same work as medical doctors. They work to heal, by figuring out what's wrong with their patients and then doing what's needed to heal them. Trump believes he's doing that.

Sometimes the cure will be obvious and easy. Sometimes it won't be. Sometimes it will hurt the patient a lot, so that the cure will be barely better than the disease. But still better.

Doctors operate under ethical guidelines, developed to guide them in doing what's best for their patients — which can mean being better people and better doctors than they would be without guidance. They're as human as anyone else and also tempted in ways many of us aren't, in particular, to confuse the service of their ego and ambition (or resentments) with the care of their patients.

Which of course is a temptation politicians share. Power tends to corrupt, as the English historian Lord Acton said, and absolute power corrupts absolutely.

Presidents don't have absolute power in the sense that the kings of old and the dictators of the modern world had it, but the power they have is so great as to be almost absolute, especially in their relation to the most vulnerable.

An American president can, for example, consign millions of people to suffering and death with a few hundred words and a sharpie signature.

First of all

The most famous example of a medical guideline is the Hippocratic Oath and particularly the famous injunction, "First of all, do no harm." The president could have learned from this. He should have practiced it.

You do (as a doctor or a president) what you have to do to heal the patient or fix the country. But you work very hard to make sure that you don't hurt anyone more than you absolutely need to. You may get less than you want but you do more good for more people.

Donald Trump didn't need to do the harm he did. Even, as I said, for his own purposes.

_____


© 2025 the Pittsburgh Post-Gazette. Visit www.post-gazette.com. Distributed by Tribune Content Agency, LLC.

 

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