Tuesday, September 6, 2011

Hippocratic Oath

More Greek Statues
Today's ethics class was on oaths of medical professionals. I have a strong respect for the Hippocratic Oath due to an excellent analysis by Leon Kass in his Toward a More Natural Science. I highly recommend his one-chapter analysis to everyone. While you read, compare the Oath and the AMA Principles. (These links will take you to scribd.com.)

The lecture was hard to take. The professor stated that the Oath's abortion clause was not a perennial proscription of abortion; rather, it was an example from the writer's time. I wish she could've heard herself! I regret not writing down her exact words, but I have a crisp memory of her point. She said very confidently, "some will tell you that this clause is forbidding abortion and prescribing deadly drugs. That is not true. It is forbidding," and she sort of hesitated, "the harm that these involve, because...ah...when you give the patient that drug you are...harming. But these examples are definitely from their time." It hurts to hear things so false, so ingrained, and held as so irrefutable.

The lecturer also remarked that the Hippocratic Oath lacks the principle of autonomy. As she said this and as the moderator remarked on the fact, I heard condemnation mixed with respectful confusion in their voices. "Certainly," they seemed to say, "Hippocrates is revered, but how could such a grave oversight stand for so long? A travesty, a deep offense to the patient...." I said nothing--so hard for a TACer!--but I wish I could have spoken. The Hippocratic Oath needs no principle of autonomy. Autonomy is like a bandage, correcting a true fault but not with a real cure.

Our discussion afterwards was mixed. On one hand, people identified what I think are key duties of the physician: treat and prevent. On the other, they wanted to include things like "respect diversity." That is another bandage. As the years progress, oaths and codes get wordier and wordier with more and more bandages. At bottom, these oaths just say "be a good person," and if everyone did this, they wouldn't need to be any longer. But to lousier people (or people who make poor judgments) the oaths prescribe the minimum behaviors necessary to avoid punishment...so our oaths get longer and longer. "A thousand laws are needed wherever a single virtue declines" (Statement of the CMA on Healthcare Reform).

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