Human Exceptionalism

Medical Elite at War With Hippocratic Oath

Yes, yes, I know: Very few doctors take the Hippocratic Oath anymore–which I have repeatedly written about here at SHS and elsewhere–because it interferes with modern cultural norms (and that includes the Hippocratic proscription against having sex with patients). But surely, physicians who still adhere to orthodox Hippocratic values should be able to practice medicine in the specialty of their choosing under what was until not very long ago, the expected approach for all doctors.

Apparently not–at least according to the medical elite. The New England Journal of Medicine has become the latest publication to publish an opinion piece that, in essence, tells physicians who don’t want to violate the Hippocratic Oath to get out of areas of medicine where non Hippocratic procedures are now allowed. From the column by Julie D. Cantor, M.D., J.D. attacking the Bush conscience clause regulations:

Medicine needs to embrace a brand of professionalism that demands less self-interest, not more. Conscientious objection makes sense with conscription, but it is worrisome when professionals who freely chose their field parse care and withhold information that patients need. As the gatekeepers to medicine, physicians and other health care providers have an obligation to choose specialties that are not moral minefields for them. Qualms about abortion, sterilization, and birth control? Do not practice women’s health. Believe that the human body should be buried intact? Do not become a transplant surgeon. Morally opposed to pain medication because your religious beliefs demand suffering at the end of life? Do not train to be an intensivist. Conscience is a burden that belongs to the individual professional; patients should not have to shoulder

Why do I suspect she wouldn’t be opposed to futile care theory? But that aside, the hubris is palpable–particularly the thinly veiled attack on Catholicism and the canard that the faith “demands suffering at the end of life.” Also, realize that if the issue is a physician refusing to participate in assisted suicide–which the Bush conscience regulations also protect–it would mean that any doctor who didn’t want to help kill patients might have to become podiatrists.

Cantor, M.D., J.D. concludes:

Health care providers already enjoy broad rights–perhaps too broad–to follow their guiding moral or religious tenets when it comes to sterilization and abortion. An expansion of those rights is unwarranted. Instead, patients deserve a law that limits objections and puts their interests first. Physicians should support an ethic that allows for all legal options, even those they would not choose. Federal laws may make room for the rights of conscience, but health care providers–and all those whose jobs affect patient care–should cast off the cloak of conscience when patients’ needs demand it. Because the Bush administration’s rule moves us in the opposite direction, it should be rescinded.

I italicized the key phrase that I think should be carefully pondered when thinking about this post: Cantor would seem to support the government legally forcing physicians who practice OB/GYN to perform abortions. That same coercive principle could also force internists, family care specialists, oncologists, hospice physicians, cardiologists, anesthesiologists, etc., to perform assisted suicide wherever that non medical act is redefined as a legal “treatment.”

I keep saying it: The culture of death brooks no dissent. But there is no reason why Hippocratic doctors have to cooperate with their own undoing. One antidote I suggest: Mass public recitations of the principles of the Oath by physicians to prove they are not cowed by the likes of Dr. Cantor, M.D., J.D.


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