It's really interesting to me how often Bruce thinks about the fact that Thomas was a doctor and his oath to save lives in relation to what Bruce does as Batman. And I do think making that comparison ourselves helps put his "no kill" rule in perspective.
Obviously Bruce does knowingly and intentionally cause harm, but his overall goal is still to save lives. Is it just of him to use his knowledge of the personal histories of the people he's sworn to save to decide whether they deserve life or death? Bruce has that power now like his father before him and he's certainly thinking about it that way.