First, Do No Harm is a real-life dramatization of the routine ethical dilemmas that healthcare professionals, patients and their relatives face on a day-to-day basis. The book reads like a novel, but author and New York Times writer Lisa Belkin maintains that every event in the book is true. This makes the experience of reading the book all the more gripping. Many of us familiar with medical ethics understand that there are difficult questions but we are rarely confronted with the real life situations where the question is relevant and the real life people who must answer it. Lisa Belkin's task is not to give us the answers, but to pose the questions in a powerful fashion. She aims to show us how real people struggled with these questions and how they came to live with their answers.

The book concerns a large cast of characters, a host of doctors, nurses, aides, parents, relatives, children, babies, and hospital administrators. It has no central main character, save perhaps Patrick Dismuke. It is structured chronologically over a six month period, May through October, 1988. The book has six parts with distinct characters and their unique dilemmas introduced each month. Some characters are recurring and their struggles continue throughout the entire book.

The setting of the book is Hermann Hospital in Houston, Texas and the main characters are either employees of Hermann, Hermann affiliates, Hermann patients or their relatives. One particular focal point of the book is Hermann hospital's ethics committee, composed of a large range of characters, from doctors to a mother with a handicapped child. The committee makes recommendations for how to resolve certain critical ethical questions concerning a patient's care. And it is with the committee our story begins.