Pushing Doctors into a “Dual Mandate” Attacks Hippocratic Oath

American physicians are threatened by their government with being forced into an untenable position. On one hand, they are professionally obligated to render optimal care to each patient based on individual need. On the other hand, they are increasingly being called upon by bureaucrats and bioethicists to serve society as health care rationing cost limitation enforcers. If current trends continue, doctors will be forced to assume a dual mandate—duty to patient versus duty to society—carrying with it an inherent conflict of interest that could tear our health care system apart.

The Hudson Institute’s Betsy McCaughey has noticed and raised the alarm in an important column published by Investor’s Business Daily , entitled “Attack on Doctors’ Hippocratic Oath.” From the column :

Patients count on their doctor to do whatever is possible to treat their illness. That is the promise doctors make by taking the Hippocratic Oath. But President Obama’s advisers are looking to save money by interfering with that oath and controlling your doctor’s decisions.

Ezekiel Emanuel sees the Hippocratic Oath as one factor driving “overuse” of medical care. He is a policy adviser in the Office of Management and Budget (OMB) and a brother of Rahm Emanuel, the president’s chief of staff. Dr. Emanuel argues that “peer recognition goes to the most thorough and aggressive physicians.” He has lamented that doctors regard the “Hippocratic Oath’s admonition to ‘use my power to help the patient to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of the cost or effects on others.”

Undermining the Hippocratic Oath—which is no longer taken by most doctors because it prohibits abortion and assisted suicide—is nothing less than the deprofessionalizing of medicine, and turning physicians into healthcare technocrats. Once cost gets into that mix, it will be open season on the weakest and most vulnerable patients—which are often the most expensive.

McCaughey continues:

But President Barack Obama is pledging to rein in the nation’s health care spending. The framework for influencing your doctor’s decisions was included in the stimulus package, also known as the American Recovery and Reinvestment Act of 2009. The legislation sets a goal that every individual’s treatments will be recorded by computer, and your doctor will be guided by electronically delivered protocols on “appropriate” and “cost-effective” care . . .

Heading the new system is Dr. David Blumenthal, a Harvard Medical School professor, named national coordinator of health information technology. His writings show he favors limits on how much health care people can get.” . . . Now that Blumenthal is in charge, he sees problems ahead. “If electronic health records are to save money,” he writes, doctors will have to take “advantage of embedded clinical decision support” (a euphemism for computers instructing doctors what to do).

Translation: Healthcare rationing, futile care (refusing wanted life-sustaining treatment) impositions, assisted suicide—always cost effective—and a “duty to die” for the most marginalized people.

McCaughey’s spot on critique illustrates a truth I have only recently fully comprehended: The political left, which has been subverting Hippocratic medical values for years and is driving these proposed “reforms,” isn’t really about promoting freedom; it is about exercising power, a commodity at its most raw when bureaucrats and utilitarian bioethicists are empowered to instruct your doctor whether can be treated or must be denied care, indeed, whether your life is worth living, or whether the time has come for you to die.