Revisionism Alert! Trying to Explain Away Changes in the Hippocratic Oath
This is revisionism on steroids. The Hippocratic Oath is no longer taken by most doctors because it has some politically incorrect clauses, such as barring physicians from mercy killing patients, abortion, and sex with patients. I have written about those matters here at SHS before. But now an ethicist writing for the BBC tries to tell us that the Oath really didn't ban assisted suicide or abortion. From the article: The next part seemingly concerns euthanasia or physician-assisted suicide, saying: "And I will not give a drug that is deadly to anyone if asked, nor will I suggest the way to such a counsel."
Oh, please. First, note that when the Oath switches topics from mercy killing to abortion, the use of the segue word, "likewise." How can the anti mercy killing issue refer to assassination when, by using the word likewise, the author is clearly saying "in the same manner, I will not use a pessary to cause abortion." He wouldn't be assassinating the woman!
Two leading scholars of the Oath, Littre and Miles, have however suggested that this passage alludes to the then common practice of using doctors as skilled political assassins. Steven Miles notes: "Fear of the physician-poisoner may be traced very close to the time of the Oath." The word "euthanasia" (meaning "easeful death") was only coined a century after the writing of the Oath.
The text continues: "And likewise I will not give a woman a destructive pessary." This passage is often interpreted as a rejection of abortion.
However, abortion was legal at the time and the text only mentions pessaries (a soaked piece of wool inserted in the vagina to induce abortion), not the oral methods of abortion also used in ancient Greece. As pessaries could cause lethal infections, the author of the Oath may have had a clinical objection to the method, rather than a moral objection to abortion itself.
Moreover, euthanasia means "good death," not "eased death," and up until the late 19th Century it meant dying at home, pain free, in a state of grace, surrounded by family. It was one of the first words co-opted by the then nascent mercy killing movement to change the language to make killing easier to accept. (See Ian Dowbiggin's A Concise History of Euthanasia.)
Trying to pretend that today's medical ethical milieu is still "Hippocratic" is nonsense--particularly when there is a movement afoot to force doctors to perform or be complicit in abortions and assisted suicides--and when physicians are no longer scorned for affairs with their patients.
Labels: Hippocratic Oath. Revisionism.
posted by Wesley J. Smith @ 8:29 AM
5 Comments
5 Comments:
That writer is not qualified to examine the oath.
Neither are you.
I would happily listen to your analysis, providing you do two things first:
1. Learn ancient written greek.
2. Become a qualified and respected historian specialising in the period.
You make mistakes like relying on the word 'likewise' as a specific meaning, when it's quite possible the person responsible for it's translation from greek used a word that seemed to fit his own interpretation. It might even not be there at all, but just something added in during translation to better smooth the flow of paragraph to paragraph. It's a basic rule *never* to do a word-by-word disection of a document in translation.
Both theories appear to be quite plausable. Neither of us are qualified to accept or reject either one. Leave it to the historians.
Steven Miles, the bioethicist writes: "Feel free to read "The Hippocratic Oath and the Ethics of Medicine" Oxford University Press. Check out the citations. Check out the reviews by the historians who took a look at it.
Charging "revisionism" after reading an op-ed piece is a cheap shot. You used to know better.
Feel free to post this as a comment on your blog."
Dr. Miles seems awfully thin skinned to me. (For those who may not know him, he is a well known bioethicist and a supporter of medical futility, although an opponent of assisted suicide. His views appear prominently in Culture of Death.) I was referring to and critiquing the article, that was promoting a view, not engaged in a book review of Dr. Miles' book.
That being said, it is hardly a "cheap shot" to note that the meaining of the Oath that was uncontroversial for so long, suddenly began to be interpreted as meaning something different, indeed a meaning that would more easily fit into the modern moral paradigm of the controversial issues of abortion and assisted suicide.
Further, I note that the new pabulum oaths most new doctors take today, don't promise not to provide unsafe abortions, or assassinate people in their role as physicians--which is what we are now told in the article that the original Oath actually meant. Indeed, modern docs no longer state that they will refrain from sex with patients, as required by the original Oath.
It seems reasonable to me that these new oaths have dropped the Hippocratic Oath's original proscriptions precisely because they were read as barring assisted suicide, barring abortion, and barring sex with patients.
The Oath was designed to promote the protection of individual patients and ensure proper (what we now call) professionalism among the physicians who so swore.
It is being dropped and dramatically altered precisely because many of its maxims do not fit with the current moral beliefs of many graduating doctors.
Doesn't the Hippocratic Oath also imply that medicine should be taught for free?
Indeed, but to be fair, back then medicine was taught through mentoring by physicians to students, kind of like Abraham Lincoln learned to be a lawyer by apprenticing in a law office. It was considered a professional duty to teach the new generation.
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