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Off topic: The Hippocratic Oath

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Recently, I was in my dentist’s office. He has been my dentist for about 35 years, and was my children’s dentist until they grew up and moved away.

He is the best dentist anyone could hope for. He delivered me from much suffering, while pulling very few teeth. (He hates  making people “edentulous,” because he knows how much they will suffer when they are old and their jaws have decayed, through lack of teeth to hold them in place.)

While I was waiting in his office recently, I chanced to see, framed on his wall, a modern version of the Oath of Hippocrates. I have sought a number of times since then the exact wording of the modern version on the Internet, but have not found it.

Basically, the Oath is pro-patient, and anti-abortion and anti-euthanasia, and anti-saving the state money by offing patients. No doctor or dentist has any business ending anyone’s life to spare the government expense or others’ inconvenience.

Here is a brief history of the Hippocratic Oath. Here is a serious challenge to it in the United States. We have recently beat back this challenge in the Province of Ontario, in Canada.

Will Americans follow our example, or just cave?

Here’s an unspeakable denunciation of the Oath, worthy of a materialist atheist culture, that should be denounced by every decent person who has aged parents. As a person who seeks care for my aged parents, you can guess which side I am on … can’t you?

As i said earlier, if anyone on this list can point me in the direction of the modern, non-pagan version of the Hippocratic Oath, I will be greatly indebted.

Comments
"I think it would be uncharitable to question the sincerity and compassion of these pro-life physicians, just as it would be a crude caricature to depict them as religious fanatics." I am not questioning their sincerity and charity - just their judgement. The link you gave leads to many, many articles and I haven't the time to read them - but I assume that these physicians think ethusiansia is always wrong. This is not surprising. There are millions of physicians in the world and there will be hundreds, if not thousands, who adopt almost any moral position you care to name. As it happens I have very experienced (retired) consultant friend staying at the moment. He points out that it is not just morally difficult but practically difficult to take an oath to avoid euthanasia. Most anaesthetics that are effective for great pain also increase your chances of premature death. In a wide range of contexts, the greater the pain-killer the higher the chance of dying somewhat prematurely. I wonder if Gpuccio is reading this? He is a doctor.Mark Frank
June 7, 2009
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Mark Frank and magnan: As I have absolutely no medical qualifications, I am in no position to comment on the cases you cite. All I will say is that a significant number of physicians disagree with you - including the vast majority of physicians who were trained before the idea of euthanasia became publicly acceptable. I refer you to the following link: http://www.physiciansforlife.org/content/section/12/33/ I think it would be uncharitable to question the sincerity and compassion of these pro-life physicians, just as it would be a crude caricature to depict them as religious fanatics. I used to support euthanasia myself, during the early 1990s. One book which helped change my mind was Rita Marker's Deadly Compassion, available at http://www.amazon.com/Deadly-Compassion-Death-Humphry-Euthanasia/dp/0688122213/ref=sr_1_3?ie=UTF8&s=books&qid=1244384843&sr=8-3 . As the old adage says: Be careful what you wish for. You may just get what you want.vjtorley
June 7, 2009
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Dying - the end of life - is a normal part of life. Every life ends - some more slowly than others - but every life ends. The medical establishment has managed to prolong the final dying process almost indefinitely (to its great profit). While life inarguably has sanctity, death does not. There is a difference between prolonging life and prolonging death, and I find that most of those who piously discuss the one have never been down-and-dirty up close and personal with the other. Anybody approaching the end of their life should make sure to complete an Advance Directive / Living Will while they can. I personally plan to have "DNR" (Do Not Resuscitate) tattooed on my right palm sometime later in life...PaulBurnett
June 7, 2009
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"We are dealing here with the problem of relative vs objective reality." I don't agree. I certainly don't intend to repeat the old debate about relative and objective morality - but in practice it makes little difference. All of us, objectivists and relativists, agree about most moral issues and disagree about some moral issues. The most strident relativist will agree (subjectively) that murder is almost always an awful thing to do and there are plenty of objectivists who believe that abortion is objectively acceptable. The key difference is the relationship between principle and practice. Do you judge something to be right or wrong by matching it against moral principles? Or do you judge something to be right or wrong by examining the details of specific situations (and then perhaps derive principles from those situations)? I believe that the former approach (whether it be based on religious, political, or any other principles) leads to the most horrendous episodes in our history. This is a much more serious problem than any slippery slope.Mark Frank
June 7, 2009
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Mark you wrote,
"If you have to live through the reality of these situations you find that sanctimonious principles, hippocratic oaths, and legislation, don’t begin to match up to the emotion and complexity of reality."
We are dealing here with the problem of relative vs objective reality. The relative perspectives of those individuals who have such problems may lead them to conclude that is it right for them to do the discussed things above of ethical and moral controversy. That is without a doubt. But is it right to delegate morality to relativity? That is, is morality and ethics absolute or relative? Ultimately there will be an absolute result and if that result impacts others it goes beyond the bounds of personal or relative experience. The absolute reality of ethics and morality is something we need to think about- and if we are true Christians, and I understand that many of us are not- we need to think about how those choices effect our hope for salvation which is much more important than any experience of this world.Frost122585
June 7, 2009
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#9 "Some people live who want to die. Far more people die who want to live." Yes - but surely we are only talking about the first case. I don't know what the situation is in Canada, but no one is Europe is suggesting that health services kill those who want to live. "And especially don’t give the funding authority for health care the power to do so." What's behind this? Maybe you are saying that a funding authority should not have the power to decide whether someone should be allowed to die because of the temptation to save money. I agree. Is anyone suggesting this? In every case I have come across the proposal is that decision is up to the patient not the medical authority. (Occasionally there is the very difficult case where the patient is unable to express their view because e.g. they are permanently unconscious or had a very severe stroke and cannot communicate.) Magnan is absolutely right. If you have to live through the reality of these situations you find that sanctimonious principles, hippocratic oaths, and legislation, don't begin to match up to the emotion and complexity of reality. It is more important to get the process right. The decisions need to be with patient and his or her loved ones ideally supported by a sympathetic physician who, of course, has the patient's best interests at heart - which occasionally might include death.Mark Frank
June 7, 2009
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Abortion is an abomination. Can you imagine if Mary decided to have an abortion because all she could find was a manger and that was not "good enough" for her child? So many people today claim they would have an abortion out of moral responsibility because they would not be able to raise their child for reasons of lack of money etc. Of course they always ignore adoption- but the truth is that in most cases the child can be provided for but only at the expense of the Mother's/Father's BMW, or nice big house etc. So abortion is almost always the sign of people choosing to make life a value contingent on convenience. Which is an abomination. As far as the suicide issue - this is a very dangerous idea that is not far from Nazism. Because if one thinks it is ok for suicide of terminally ill people- then the slippery slope becomes obvious- depressed people, retarded people, minorities or ethnic groups (and these things have happened many times), even people who are just not "elite" can be justified in euthanasia. This is the degradation of the value of existence and being, life and love. And not to mention that there is so much room for people to trick people into wanting an assisted suicide so that they can get their money through wills and what not. All evil ideas come about by getting us to open the door just a crack for them to get their foot in- and then they bum rush their way in. A societal moral melt down leads to evil every time and such meltdowns begin with seemingly tough ethical questions like, "is it better to be dead or alive in such and such situation?" As if it is right to choose death over life. Ideas of "justified War", "fixing poverty"- "treating illnesses with certain questionable drugs and means", free love and sexuality, legalized drug use, the list is endless, "clever" political and business schemes of unethical nature, liberal theology which allows for sin, etc All these evil ideas begin with a seemingly moral or ethical dilemma and then fool us into thinking they might be good- but then they always lead to much more harm than then good. That is what good Christians call the trick of Satan who will give up a little to gain a lot. People need to be aware of the deception of desires for things of the flesh- because there is no hard ethical guidance that can be found outside of a uncompromising belief in the sanctity of life.Frost122585
June 6, 2009
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Magnan, 8 wrote: "“Basically, the Oath is pro-patient, and anti-abortion and anti-euthanasia, and anti-saving the state money by offing patients. No doctor or dentist has any business ending anyone’s life to spare the government expense or others’ inconvenience.” I guess this means you are in favor of this interpretation of the Hippocratic Oath. It is easy to take such a religiously oriented stance regarding human suffering while distant from the realities. In my experience idealism usually decreases in direct proportion to the proximity to the actual situation. " Magnan, I do not know how or why you or anyone else supposes that (1) either I or my dentist do not know about suffering, or that (2) the Oath is an exercise in futile idealism. Some people live who want to die. Far more people die who want to live. You can't give life to the latter, so don't be too hasty to take it from the former. And especially don't give the funding authority for health care the power to do so. The physician (doctor, dentist, nurse, technician, etc.) should be the patient's advocate for the best possible life for that person at this time. There are lots of people out there who will gladly be advocates for all kinds of other causes - that I well know. But the physician is like the defense lawyer. She is there for her patient as long as life of some kind is possible. Speaking for myself, I have often seen people come back from circumstances in which they were written off. Not always, but often enough to be cautious, and therefore very unwilling to sign on to non-Hippocratic approaches. I think the ol' Greek coot Hippocrates had a good idea there. Greeks call it "nous", right?O'Leary
June 6, 2009
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"Basically, the Oath is pro-patient, and anti-abortion and anti-euthanasia, and anti-saving the state money by offing patients. No doctor or dentist has any business ending anyone’s life to spare the government expense or others’ inconvenience." I guess this means you are in favor of this interpretation of the Hippocratic Oath. It is easy to take such a religiously oriented stance regarding human suffering while distant from the realities. In my experience idealism usually decreases in direct proportion to the proximity to the actual situation. This is really far off the usual intended focus of the forum, but you have touched one of my "buttons". I apologize if the following is is too intensely negative for some people, but the reality is that there are endless horrendous examples of long, slow, incredibly cruel dying that can take years, to say nothing about purely mental and emotional suffering. Needless, pointless suffering that basic human compassion would dictate should be mercifully ended. I would like to cite an example from my own experience, in periodically visiting and trying to comfort a member of my wife's family who had had a severe stroke. It took him five years to die. He was severely disabled by the first stroke, necessitating a 24-hour medical care nursing home. At the beginning he was still able to speak a little, and said he wanted to die. He repeated this on several subsequent visits while he was still able, using paper and pencil, with a terrible begging desperation in his eyes. He was in constant physical pain due to various effects resulting from the stroke and being bedridden. His condition slowly, gruelingly worstened so that in the last couple of years he was shrunken, twisted and incoherent. But he still was conscious to a degree, and obviously continued to suffer terribly despite being incapable of coherent thought. This was not a fictional horror story. In the absence of doctor assisted suicide this sort of thing happens frequently. I would like to propose a thought experiment: put yourself in my place on one of my visits, see if you can rise above any instinctive fear of one day going through the same nightmare ending, and see if you can feel the spiritual and religious doctrinal-based goodness of letting this person continue this "life".magnan
June 6, 2009
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Real moral decisions require real contexts. I was extremely close to this one .... The father of a close friend of mine got terminal lung cancer when he was 84. He was in a great deal of pain and bed ridden. He had a very distinguished career in the RAF. In the war he was a bomber pilot who completed three series of ops (if you know the odds you will appreciate how lucky he was). He appreciated his good fortune and the extra 60 years of a full life. He did not want to finish in pain and humiliation. He asked his family if he could "get it over with" and the family doctor tactfully steadily increased the morphine dose. He died at peace at home in his wife's arms. Were the chidren failing to care for their aged parent? Should the doctor have been denounced for failing his hippocratic oath? Should the father have been denied the choice? Should anyone who was not part of this family be allowed to pontificate on what was right and wrong?Mark Frank
June 6, 2009
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djmullen: You wrote "You’re probably upset that the article points out that, “relieve his necessities if required”, may be a homosexual reference. You may be upset by that, but you shouldn’t be surprised." Mullen, if you try any more amateur Freudianism about me, I will ban you from this list. I am concerned about tacit euthanasia of old folks - and justifiably so, given what is happening in Europe today. If you want to practice psychoanalysis without a licence, do it on your own acquaintances, who can advise each other when the bin is full of compost and needs emptying. Freeman, thanks for the johnpatrick reff. Should have thought of that myself!; he is a fellow Canadian, and probably has the same version as my dentist has framed - as have many other highly respected practitioners of the Hippocratic arts here. PaulBurnett: I can't comment on toothlessness patterns in the United States. In Canada, toothlessness is discouraged, due to longevity. Teeth, even if they are not very good, keep the jawbone from starting to disintegrate over time. Many elderly people suffer unnecessary problems due to inability to eat properly, and tooth loss is a factor - it restricts what the person can eat and leads to a loss of interest in eating, hence malnutrition and progressive weight loss - mostly unnecessary. The old-fashioned notion that lots of problems can be solved just by pulling all of a person's teeth assumed a much lesser longevity than is currently the case in many technologically modern societies. vjtorley, thanks very much for the reff to physiciansforlife. I will doubtless come across my dentist's wording there, as I suspect he has been a strong supporter. Such declarations are immensely comforting to patients.O'Leary
June 6, 2009
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Hi Denyse, My last post was a bit rushed. The link I sent you was actually a trendy "update" penned by Dr. Louis Lasagna in 1964, which fails to preserve the pro-life and anti-suicide intent of the original Oath. However, this 1995 rewrite of the Hippocratic Oath contains a pledge to protect human life from fertilization until natural death: http://www.physiciansforlife.org/content/view/28/29/ I hope that helps.vjtorley
June 5, 2009
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Denyse I looked up the Wikipedia article on the Oath. Here's a link. http://www.pbs.org/wgbh/nova/doctors/oath_modern.html Is this what you were looking for?vjtorley
June 5, 2009
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Denyse wrote: "He is the best dentist anyone could hope for. He delivered me from much suffering, while pulling very few teeth. (He hates making people “edentulous,” because he knows how much they will suffer when they are old..." In 2004, the Centers for Disease Control published the results of a study of "Adults aged 65+ who have had all their natural teeth extracted." They then ranked all of the states by the percentage of such adults in each state (see http://www.statemaster.com/graph/hea_ora_hea_los_of_nat_tee-health-oral-loss-natural-teeth ). I decided to add value to the list by annotating the dataset as to whether the states had voted for Bush or Kerry in the 2004 Presidential election; four years later I added another column showing the McCain-Obama results (see http://www.paulburnett.com/toothless.htm ). The graphic is astounding. Why would the most toothless states so uniformly vote Republican?PaulBurnett
June 5, 2009
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I believe this site by a fellow Canadian, johnpatrick.ca, may be of help.freeman
June 5, 2009
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"Here’s an unspeakable denunciation of the Oath, worthy of a materialist atheist culture, that should be denounced by every decent person who has aged parents. As a person who seeks care for my aged parents, you can guess which side I am on … can’t you?" I don't understand how you find two sides, at least regarding aged parents. The Hippocratic Oath compels the doctor to share his goods with his teacher and his teacher's children. The "Hypocrisy and the Hippocratic Oath" article points out that this will necessarily be at the expense of his own parents and children. I don't see anything anti-elderly parent there. You're probably upset that the article points out that, "relieve his necessities if required", may be a homosexual reference. You may be upset by that, but you shouldn't be surprised. Hippocrates, or whoever wrote the oath, was not a conservative Christian, he was an ancient Greek and his religion and morals were from his Greek culture. The oath was sworn to the gods Apollo, Aesculapius, Hygiea and Panacea and "all the gods and goddesses" by a man living in a culture where homosexual relations between master and student were considered normal. Present day conservative Christians don't approve of any of that sort of stuff and they would do well to read the oath skeptically before endorsing it.djmullen
June 5, 2009
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