I received a strong reaction to the post about Cornell Medical School weakening the Hippocratic Oath. Today, I heard from a LLU alumnus, concerned about the LLU Medical School's
weakening of the Oath. It purports to be a Christian version (no swearing to Apollo, etc., which is appropriate). Unfortunately, the LLU Physician's Oath doesn't just contain pabulum, but could also turn out to be applied in an anti-patient manner in some cases:
This is the provision I have the most concern about: "Acting as a good steward of the resources of society and of the talents granted me, I will endeavor to reflect God's mercy and compassion by caring for the lonely, the poor, the suffering, and those who are dying."
This provision does away entirely with the doctor having his or her sole duty to the wellbeing and health of the patient. It seems to place a dual mandate on doctors, to husband resources first, as he or she cares for patients. Indeed, this statement would seem to justify health care rationing, thereby placing the swearing doctor into a potential conflict of interest with his/her most ill, elderly, or disabled (most expensive) patients.
This is not to say, of course, that it is wrong for physicians to be concerned about proper use of resources. They should be. But not at the expense of the proper care of the individual patient, to whom physician should owe the highest duty of loyalty as an individual
. Dual mandates, if you will, are dangerous precisely because resource management could easily come to trump the patient. The clause would also justify imposition of Futile Care Theory
, (aka, medical futility)."I will maintain the utmost respect for human life. I will not use my medical knowledge contrary to the laws of humanity. I will respect the rights and decision of my patients."
Well, this is a complete cop out. Why not explicitly promise not to kill patients, regardless of what the "laws of humanity" might state? In the Netherlands, the law will soon permit the active infanticide of disabled and terminally ill infants. Under this oath, a doctor could comply and not be in violation. After all, the Dutch doctors who commit infanticide state they do so because they respect the humanity of the patients they kill, who they claim, do not have "livable lives." "I will lead my life and practice my art with purity, and honor; abstaining from immorality myself, I will not lead others into moral wrong doing."
This replaces the promise not to have sexual relations with patients. Since it comes from a presumably conservative Christian context, it may pass muster. But absent that, it is entirely vague. Why be coy?
I would be interested in other examples of modern medical oaths. This trend to do away with robust patient protection is alarming, to say the least.