GESTIÓN EN SALUD PÚBLICA: BioEdge: Back to the source: the Hippocratic Oath re-examined

domingo, 17 de marzo de 2019

BioEdge: Back to the source: the Hippocratic Oath re-examined

BioEdge: Back to the source: the Hippocratic Oath re-examined

Bioedge

Back to the source: the Hippocratic Oath re-examined

by Michael Cook | 15 Mar 2019 |

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Over the centuries the Hippocratic Oath has expressed the ideals of the medical profession, although nowadays other versions have supplanted it for graduating medical students– if they take any oath at all. If taken literally the Oath is an anachronism. Who today “swears by Apollo Physician, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses”?

But T. A. Cavanaugh, a philosopher at the University of San Francisco, argues in his recent book Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession that the Oath is still relevant in establishing the fundamental ethics of the medical profession—to help and not to harm the sick.

Steeped in Hellenic culture and philosophy, Cavanaugh argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession.

Medicine as a profession, Cavanaugh contends, necessarily involves declaring the good one seeks and the bad one seeks to avoid on behalf of the sick. The idea of taking an oath implies that doctors set boundaries around what they are permitted to do. Medicine must reject the view that it is purely a technique lacking its own unique internal ethic.

Michael Cook is editor of BioEdge.

A California family was outraged recently when their grandfather was told that he had very little time to live by a "robot", or rather, what the media described as a robot. In fact, it was a teleconference screen mounted on a robot lectern. I don't suppose that the distinction makes much difference. The elderly man's children and grandchildren were horrified by the cold detachment of the procedure.

The hospital apologised, of course, but the incident is symptomatic of the impersonality which pervades our culture. Prodded on by our love affair with technology, human relations are being reduced to formal interactions. It may be overstating it to say that competence in face-to-face contact is a dying art -- but something is changing. To have a dozen Facebook "friends", for instance, is hardly the same as having a dozen friends.

But an even more -- I was thinking of inserting the word "sinister" but I won't -- application is the reduction of human sexuality to the twin and separable functions of recreation and reproduction. In an article below, British IVF pioneer Simon Fishel predicts that robots will handle the whole process of conception, from harvesting gametes to transferring embryos.

It seems to me that defending humane relationships will be one of the key challenges to bioethics in the coming decades.