Surviving Medicine Part 4: The Hippocratic Oath

The advent of the scientific method has produced great human triumphs over the vagaries of nature, especially when it comes to healing sick bodies. Modern ‘healthcare’ is a miracle of human ingenuity and business innovation. However, many of the medical treatments on offer today and in the past are not based on any an ethical framework. Much of what the health industry and health authorities both advise and mandate does more harm than good. Money is a factor in the healthcare industry even if it’s offered by the government. In this series, I’m seeking to tell the stories of treatments that are miracle cures, incredible advances, and spectacular disasters. Negotiating the world of doctors, medicines, treatments, and bureaucracies is necessary if one wants to reap the benefits and avoid the disasters.

The human body was poorly understood for most of human history, and it wasn’t until there was enough wealth and free time that human biology could be more fully investigated. Perhaps wealth and time also allowed the human body to acquire disorders that the hunter-gatherer societies didn’t have or didn’t live long enough to have.

The earliest of the philosopher doctors was a Greek named Hippocrates and little is definitively known about what he said or did. It is generally agreed that he was born around 460 BC on the Greek Island of Kos and he came from a family of educated men. He is credited with many sayings and things, but the principal contribution to medicine was his theory that disorders of the body were caused by natural things and not Gods or curses. Hippocrates separated medicine from religion, and this opened the doorway to the medicine we know today.

The system of human health he developed was based on the idea of ‘humors’ or ways of being that were part of an observation of different kinds of people and dispositions. The various humors are physically encapsulated into four substances: black bile, yellow bile, phlegm, and blood. They correspond to the four temperaments which are phlegmatic, choleric, sanguine, and melancholic. One can see the nascent medical and psychiatric industries germinated here. Hippocrates was an incredible innovator and genius for his time. The Hippocratic Oath, as it has been passed down to us, is part of a larger teaching and code of behavior for physicians. It is widely believed that the “First, do no harm” was part of the oath but the oldest surviving copy, which would have been written centuries after Hippocrates lived, doesn’t exactly say that. This is what the original system of medical ethics, still said to be in force today, says in full:

“I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.

I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master’s children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.

With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.

Nor shall any man’s entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.

Further, I will comport myself and use my knowledge in a godly manner.

I will not cut for the stone, but will commit that affair entirely to the surgeon.

Whatsoever house I may enter, my visit shall be for the convenience and advantage of the patient; and I will willingly refrain from doing any injury or wrong from falsehood, and (in an especial manner) from acts of an amorous nature, whatever may be the rank of those who it may be my duty to cure, whether mistress or servant, bond or free.

Whatever, in the course of my practice, I may see or hear (even when not invited), whatever I may happen to obtain knowledge of, if it be not proper to repeat it, I will keep sacred and secret within my own breast.

If I faithfully observe this oath, may I thrive and prosper in my fortune and profession, and live in the estimation of posterity; or on breach thereof, may the reverse be my fate!”

There is a reason this oath is still with us. It is, in so many wonderful ways, comprehensive. The doctor is to do everything possible to restore health and preserve life, and not exploit the position. The doctor is to share knowledge and best practices and bring honor to the profession.

No one needs me to point out that many doctors, and the profession overall, often fails to meet any of these standards. We know doctors do medically unneeded things or prescribe unneeded medications because it is their financial interest. The statistics around the behavior of the individual doctors in the medical profession are beyond question.

My own observation is a sort of feudal system in most offices where mostly young women work in the front and a man, the doctor, sees patients, briefly. Status is clearly an issue in these offices. The women defer to the doctors overwhelmingly, and men from male dominated cultures make this power discrepancy even more overt and obvious. My doctor’s office is set up that way, and I get fine care there, but the situation seems ripe for personal and professional abuse. I’ve been told revolting stories by many who encounter this exact situation. Some doctors simply do not live the oath.  

To survive interaction with the medical authorities, finding doctors that take their Hippocratic oath seriously is essential. You can’t know everything about that doctor, but observing the little things in the office and in the doctor’s personal behavior is often telling. Read the oath, and then look around at your doctors and ask, are they setting that kind of standard in their office and in their practice? If you sense a problem, it’s probably there. Find the right doctor with the right ethics, first and foremost.

Beware the doctor who says he or she only follow the science. All learned professions need philosophies and ideas to guide them where the science doesn’t exist or is contradictory: Ideology and the Ultimate Evil

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