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Hypocrisy Oath

The Great Divide Between Principal And Practice In Modern Medicine

Hypocrisy Oath -- The Great Divide Between Principal And Practice In Modern Medicine

By Nicholas Regush

There is a disconnect between idealized physician conduct and actual medical practice. Recent efforts over several years to create a charter for medical professionalism is unfortunately an exercise in fantasy.

This month, in both the Annals of Internal Medicine and The Lancet, two prominent medical journals, a report was published that consists of three principles and ten commitments to give "medical professionalism" a boost " in the new millenium."

It's called a "physician charter" and is essentially a fleshing out of the Hippocratic Oath, in one version or another sworn by medical students about to become doctors.

The charter is the product of several years of labor by various medical leaders and was spurred, in order to deal with "changes in the health care delivery systems in countries throughout the industrialized world" that "threaten the values of professionalism."

The lead-in to the publication of the article, in the Annals, refers to the 4-page "chilling brevity" of the charter and the belief of the charter's authors that "the conditions of medical practice are tempting physicians to abandon their commitment to the primacy of patient welfare."

The idea is to tack on the charter to the current versions of the Hippocratic Oath being sworn by students at most medical schools - and it is hoped that this will somehow provide an invaluable moral package to further medical professionalism.

The old Hippocratic Oath - one of the most famous documents of antiquity - is actually rather vague. It, for example, speaks to treating the ill to the best of one's ability and to preserve the privacy of patients. I particularly like the exhortation that, "Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption."

Classic Hippocratic Oath

The Charter on Medical Professionalism

Because of the brevity of this oath and changes in our society, many medical schools have created their own mini-versions of the oath. For example, some have made references to Godliness and only few of the oaths insist that the new physician should be held accountable if he or she does not abide by the oath ("But should I trespass and violate this Oath, may the reverse be my lot.")

On the subject of abortion, the classical oath says: "I will not give to a woman a pessary to produce abortion." As it turns out, only a few percent of the modernized versions of the oath renounce abortion.

I can imagine many medical students swearing to something that they either cannot comprehend sufficiently because it is too vague and out of date, or swearing to something that they cannot even believe in.

Hence the new charter for medical professionalism. It refers to principles such as:

1. The primacy of patient welfare - in other words, serving the interest of the patient.

2. Having respect for patient autonomy - "doctors must be honest with their patients and empower them to make informed decisions about treatment."

3. Making an effort to "eliminate discrimination in health care, whether based on race, gender, socioeconomic status, ethnicity, religion, or any other social category.

And the new charter refers to commitments such as:

1. Being honest with patients.

2. Maintaining patient confidentiality.

3. Improving quality of care.

Nice talk and no doubt some food for thought for all those medical students who are going to be descended upon by the pharmaceutical industry the moment they call themselves "Dr."

Sorry. This charter is so much out of line with modern reality that those who are now going to try to foist this piffle on medical students deserve our contempt.

What Medicine needs is some straight talk such as:

1. Under no circumstances should a physician make deals with drug companies that might interfere with thorough consideration of potential treatments.

2. Under no circumstances should a physician accept any sort of gift or favor from a corporation - including items for the medical office.

I'm sure you get the picture. Every feature of modern medicine has been corrupted by cash - patient treatment, particularly drug prescription, clinical trials, diagnostic services, and, of course, surgery (with its extraordinary high rates of useless, dangerous, untested and inappropriate procedures).

Medicine Is Awash In Corruption

It has become more and more difficult to detect which doctors are working in the public interest or their own financial interests. The practice of psychiatry is an obvious example with its penchant for creating phantom diseases and prescribing mind drugs to anyone - adult, teenager and infant - who hints at being emotionally unstable.

To think that some charter, offering moral guidelines in the absence of a complete overhaul of a rotting medical system, will do anyone any good stretches the imagination.

What these probably well-intentioned people who put this charter together should do is get out of their ivory towers and look smack into the hypocrisy that is killing medicine.

Red Flags Weekly March 4, 2002


I couldn't agree more with Nick Regush on this issue. Nick was one of the most clued in reporters when he worked for ABC News. After ten years at ABC News, he turned to developing his own website, in hope of advancing the cause of free expression in journalism. He feels today that television news has become a shell of what it once was and that the future of news is on the Web.

However, he has retained many of his media network contacts and plans on using them to help transform the health news coverage of the system. Since we both share similar passions we have agreed to work on collaborative efforts in the future. His new site is one that should be reviewed on a weekly basis.

The mission of is to probe medical, scientific, environmental, artistic and political issues in a manner that one rarely encounters in mainstream news reports. Corporate bottom lines and inadequate training in specialty journalism often provide the reading, viewing and listening public with narrow and simplistic information. To subscribe to their free weekly newsletter CLICK HERE.

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