The Diamond Rule: When Ethics Become Understanding
- Edward Walsh
- Feb 17
- 2 min read
In my previous blog, I discussed why the Platinum Rule for healthcare and particularly persistent pain care surpasses the Golden Rule.
The Golden Rule is simple and familiar. Treat others as you would like to be treated.
The Platinum Rule refines this. Treat others as they would like to be treated.
In clinical practice, especially when working with people living with persistent pain, this distinction matters. What feels helpful to a clinician may feel dismissive, frightening, or overwhelming to the person in pain. Asking what the other person needs and values is often the more ethical and effective approach.
And yet, something about this conclusion niggled at me.
The Golden Rule is not just an old saying. It is attributed to Jesus in Matthew 7:12, delivered as part of the Sermon on the Mount. One of the most influential moral teachings in human history.
How could such a foundational principle be improved upon by a more recent reformulation?
It occurred to me that perhaps it is not being improved upon at all.
The Platinum Rule does not contradict the Golden Rule. It clarifies how it must be applied in the real world.
The Golden Rule assumes that I understand you well enough that what I would want is a reasonable proxy for what you would want. In situations where experiences are shared and symmetrical, this works.
Persistent pain is rarely symmetrical.
Pain changes priorities, sensitivities, fears, and needs. What feels reassuring to one person may feel minimising to another. In this context, the Platinum Rule offers a practical safeguard. It reminds us to ask, to listen, and to remain curious.
But there is a deeper way of understanding the Golden Rule that brings both principles into alignment.
If I take the time to genuinely understand another person’s experience, there can be moments where the preferences I identify with loosen their grip, and the boundary between “me” and “you” becomes less rigid. At that point, treating you as I would like to be treated and treating you as you would like to be treated no longer feel like competing ideas. They converge.
This is what I have come to think of as the Diamond Rule.
Not as a replacement for the Golden or Platinum Rules, but as a way of holding both at once.
It recognises that while we are different in circumstance, history, and nervous systems, ethical care emerges most reliably when we relate to others as experiences to be understood.
In healthcare, and particularly in persistent pain care, this shift matters. It moves us away from assumption and towards attunement. From doing to someone, towards working with them.
Perhaps the Golden Rule was never incomplete. Perhaps it simply requires the depth of understanding that modern healthcare is still learning how to cultivate.
Reading this through a physiotherapy lens, it feels grounded in ethical and moral care especially when working with people in pain.
We’re taught frameworks, how to assess, diagnose and treat, but pain doesn’t arrive in clean clinical lines. It comes layered with fear, history, identity, and often stories patients don’t fully voice.
What you describe as the “Diamond Rule” feels closer to what good care asks of us. Not projection, but curiosity. Not assumption, but presence. To ask: who is this person in front of me, and what does their pain mean to them?
That’s where care shifts from something purely clinical to something more human.
Really appreciated this thank you for sharing it.