Hippocratic Oath

I’m not totally convinced by this argument, but I want to put it out there to see what others think.

Supposedly the so-called “Hippocratic oath” was written by Hippocrates (“the father of Western medicine’) or one of his students in the early part of the fifth century B.C.E. It is widely recognized and is an oath that is taken by most, if not all, practitioners of the science (art?) of medicine, though in this country a more modern version is sworn to rather than the antiquated version. The modern version was written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today. So far as I know it does not require the swearer to pay allegiance to the almighty dollar, but many physicians seem to have taken that oath as well. In any event, the oath, as written by Dr. Lasagna is (in part) as follows:

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

In a word, the physician vows to take “all measures which are required” to preserve and enhance the lives in his or her care. The question I have is ethical, if not moral: should physicians be required to take this oath in this day and age — given the fact that the world population as of this writing has exploded to 7 billion 319 million (and counting). The growth of the human population so far this year is 34,962,750. Many theorists who have studied this phenomenon insist that the earth has already reached its carrying capacity. And with global warming making future food production problematic, at best, one needs to seriously ask whether it is ethically right to prolong life when it is attacked by a deadly disease. I admit that there are serious questions about who chooses to terminate life and when the decision should be made, but I shall ignore those questions to simply ask the central question: why prolong human life?

The spiritually certain, of course, insist that human life is sacred and they abhor such things as abortion (while at the same time a great many of them support war and capital punishment). Many of us on the fringes of Judeo/Christian belief might agree. But just because large numbers of people think that human life is sacred doesn’t make it the case. It may simply be a strong feeling we have all grown up with and we have been unwilling to question. I question it here, not to be facetious but because I do believe that such hard questions will soon be forced upon us by factors beyond our control — such as major storms, drought, famine, and super viruses that attack living organisms and which are not treatable. Indeed, at some point physicians may not be able to prolong life. The question before us is whether it makes any sense today to be blindly embracing a policy that may increase, rather than decrease, human suffering on this earth.

I’m not advocating a program of enforced euthanasia — though if such a program were in place I would suggest we take a page from Shakespeare and start with the lawyers, or at least the politicians! But we need to keep an open mind about the possibility of euthanasia for the terminally ill; take a more vigorous approach to family planning, including the promotion of the virtue of having small families; keep in mind that abortion is the woman’s choice; and accept as a given fact that there are people in this world who do not want to have children (or shouldn’t have them if they do) and may even want to choose a partner of the same gender. Our thinking about the so-called “sanctity of human life” is little more than a deep-seated prejudice — not shared by many other cultures, as it happens, and relatively recent if we take history in the large. Think about it: why should human life be considered any more sacred than that of other living creature?

So we might want to alter the Hippocratic oath to simply ask physicians to seek to prolong life as long as reasonable, rather than keeping folks alive at huge expense to their families and with little or no hope for recovery in a world where increasing numbers of people are crowding their way to a rather small table.

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