Physician-assisted suicide, torture, and Hippocrates: He may be old, but (let’s hope) he ain’t dead yet

A recent op-ed piece in the Chicago Tribune avers that Hippocratism is dead; and since Hippocrates’ oath is all that stands in the way of that particular exercise of compassion and patient autonomy known as physician-assisted suicide (PAS), let’s just acknowledge the oath’s irrelevance and wash our hands of it so doctors can get back to the business of killing patients. The oath has “marginal relevance” today, it is a “flimsy shield” which cannot withstand “the drumbeat of change.” “Since medicine has already discarded the vast majority of the Hippocratic oath why adhere to” the bit about not killing patients?

I have not time or space to address all of the specious arguments put forth in the editorial. But in light of the recent Senate report on CIA torture tactics, which revealed the collusion of physicians in planning and carrying out that torture (as publicized by Atul Gawande on Twitter), we had better hope that the op-editors are wrong about Hippocrates’ demise. Because if society needed a shield like the Oath to protect it from the powers of its physicians back in Hippocrates’ day, it needs it even more desperately now, when the powers of medicine to perform evil have increased as immensely as its powers to perform good. I do not know what motivations were behind the actions of the physicians who worked for the CIA: Patriotism?  The desire to protect loved ones from terrorists? Whatever they were, it is clear that even good motivations — compassion (in the case of PAS), patriotism (in the case of torture) — can lead physicians to perform unethical acts, acts whose effect is to knowingly cause harm those under their “care.” The Oath’s power to protect patients comes because the Oath doesn’t appeal to elastic concepts like “compassion,” “dignity,” or even “sanctity of life”; instead, it simply says, “I will not kill. In the course of my work I will do what is best for my patients” — not what’s best for me, or my country, or my family, but my patients.

So instead of euthanizing Hippocrates, we should be doing everything to reinvigorate the ethical values associated with his name. Because if the op-editors’ dream ever comes true — if Hippocratism dies out — then we are all in trouble; because any one of us may find ourselves at the mercy of an unrestrained, powerful techno-medicine, especially if somebody thinks we are too old, or too sick, or too weak, or too poor, or too disabled, or too inconvenient, or too suspicious-looking. . .

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