Dr. Warren A. Kinghorn, Dr. Matthew D. McEvoy, Dr. Andrew Michel, Michael Balboni, MDiv
Field of reference: Health
Description: View from group of MD's on medical treatment, policy making etc. by what moral basis this is established in modern times
"On what moral basis did all but one of the graduating classes decide which of the Hippocratic stipulations to modify or delete? It is there—not in the oath itself, but in the patterns by which the oath has been selectively appropriated and modified—that the true grounding community traditions of modern professionalism can be found. If Hippocratic maxims such as primum non nocere have survived, it is more because the moral traditions that currently inform medical ethics (e.g., human rights, liberal individualism) have found them useful and relevant than because they are part of the Hippocratic corpus per se. The Hippocratic ideals, including primum non nocere, would be inconsequential for modern medical practice if there were no living moral communities to foster, sustain, and practice them. For example, the practice of professional courtesy—treating fellow physicians and their dependents without charge—was once a common professional practice that derived from the language of the Hippocratic Oath. In the modern world of insurance copayments and managed care, this courtesy is rarely practiced and is viewed as an optional professional practice by the AMA, despite its Hippocratic foundations.
Some may reply that the Hippocratic tradition is a straw man and that these modern grounding narratives may still be defined as intrinsic to the practice of medicine. We affirm and celebrate the common heritage of caring for the sick and suffering that has been cultivated by generations—indeed, centuries—of physicians. There is much to be learned from this collective history; but is it a necessary or logical conclusion that a physician’s encounter with patients who are sick will encourage the cultivation of the professional virtues of altruism, respect, benevolence, and so on? The numerous counter examples both in history and in the present suggest otherwise. Medicine has had many embodiments throughout history, from the Hippocratics to the reductionist physicians whom they opposed, to the monastic physicians of the earliest charity hospitals, to early professionals such as Percival and Gregory, to the physician–scientists of the modern academic medical center. In each of these cases, medical care has existed in a particular cultural milieu and has been profoundly influenced and directed by the prevailing moral community traditions of the broader culture. The experience of physicians in caring for the sick can inform and influence these broader community traditions, but it cannot supplant them. Working with undeserved populations can strengthen our commitment to economic justice, but only if we already think that justice is a goal to be pursued; sitting with vulnerable and suffering patients can strengthen our commitment to altruism, autonomy, and respect, but only if we already believe that the vulnerable should not be exploited. Modern medicine, as it has done in the past, must look outside itself—that is, beyond its own methodological and clinical practices—for grounding narratives sufficient to sustain the professional virtues."
| שייך לנושאים: 1-13 - חינוך אינטגרלי, -מקורות מדעיים, התפתחות האגו, 4. יאוש וניכור |
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