What Would Hippocrates Do?

Published: April 7, 2010

By Jim Lichtman
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Doctors are familiar with the Hippocratic Oath – a pledge taken by incoming physicians that they will practice medicine in an honorable way.

However, one partisan urologist in Mount Dora, (a little town not far from Orlando, Florida), has allowed politics to intrude into his practice. Dr. Jack Cassell posted a sign on the front of his office that states: “If you voted for Obama seek urologic care elsewhere.  Changes to your healthcare begin right now.  Not in four years.”

Interviewed by the Orlando Sentinel, Dr. Cassell insisted that he would not refuse to treat any patient because of politics.  “That would be unethical,” he said.

However, Cassell’s statement clearly seems to contradict hisown posted sign in which he tells patients who voted for President Obama, quite unambiguously,  to “seek… care elsewhere,” and that “changes… begin right now,” indicating the passage of the new health care policy.

His meaning seems quite clear: Dr. Cassell’s health care policy will now be based on political disposition, rather than need.

I asked John Baldwin, a vascular surgeon, friend and former “Ethical Hero of the Month,” for his take.

“I believe he is within his rights,” John said, “but may find some contradiction in the Hippocratic Oath… If he has Emergency Room call, he cannot pull that one.  He will also be accused of discrimination, which conceivably could generate a lawsuit which could cost him a bunch of money.”

And Hippocrates, the Greek physician considered the “Father of Clinical Medicine,” how would he weigh in?

During the 5th century BC, a doctor could be bribed to see that a patient died.  If a ruler wanted to do away with an enemy he could hire a court physician who would see that the individual became sick and died.

Nevertheless, Hippocrates taught that physicians should treateveryone the same, eventually establishing a code of conduct by which all physicians would pledge to practice their skills in nothing less than an honorable manner. I will prescribe regimens for the good of my patients,” read part of the original text, “according to my ability and my judgment and never do harm to anyone.”

The contemporary version of the Hippocratic Oath is comprehensive in honesty, respect, responsibility, diligence as well as compassion.  It represents one of the best ethical codes of any profession.

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

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

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

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

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 to 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.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter.  May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of health those who seek my help.

So, what would Hippocrates do when it comes to politics and a physician’s duty?

You tell me.

 

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