This longish thoughtful response to my column on the Hippocratic Oath is worth posting on its own. This physician believes the Oath is a “living document,” that must change with the times. Well, doctors sure don’t swear by Apollo anymore, but I think this idea of a living Oath means that it can be deconstructed, which is precisely what is happening. In any event, here is the letter and my brief further response will follow:
“The oath is much more like a secret handshake than it is like the constitution of the United States. We look to it with reverence in that it reminds us that our duty to our patients is a sacred one. But it is not really possible to take it literally, unless you cherry pick. The oath forbids surgery and abortion. It enjoins us to teach our art to the sons of other practitioners (at no charge. Whatever you think of these strictures, you have to agree that they form no part of modern medical practice. Furthermore, the maxim “first do no harm” has a nice ring, but is not nearly as applicable to medicine today as the equally ancient and revered “you can’t make an omelet without breaking a few eggs”. We do a lot of harm with our surgery and chemotherapy. We do much more good, of course. The notion of avoiding all harm takes the life out of any possible risk/benefit approach to treatment.
