I Pledge Myself

I asked several young doctors who have completed medical school in the last 5-10 years which oath they took upon graduation.  No one could remember, and some weren’t sure whether they took an oath at all.  Really, an oath of any kind is out of place in a culture that doesn’t value making a statement that binds oneself.  There is very little agreement on what theory of medical practice to which one might adhere.  One of my professors mentioned in her Hippocratic Oath lecture that the prohibition against giving “a woman a pessary to cause an abortion” was not really a prohibition against performing abortions.   In the days following World War II, the Physician’s Oath of the World Medical Association pledged “even under threat, I will not use my medical knowledge contrary to the laws of humanity.”  Today, the American Medical Association, a WMA member, recognizes there is disagreement on the usefulness of the Hippocratic Oath, states that it’s Principles of Ethics define behavior but are not laws, and notes that regulatory agencies—which do not administer oaths—have the real means to respond to physician behavior.

Albert Jonsen, et. al’s Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine states that “physicians must avoid exploitation of patients for their own profit or reputation.”  It’s hard to understand how such a platitude is to play out in the real world if physicians do not pledge themselves to it.  I heard a doctor once refer to the lucrative nature of a pulmonology specialty as “the gravy train.”  Many frame their practice in terms of which procedures bring in income.  This seems odd; because according to this model, the absence of illness is a business failure.  As Maimonides would say, “the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.”

 

 

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