The
Hippocratic Oath taken by medical professionals and capitalism mutually
exclusive. Once you introduce the idea
of health care being a profitable business you remove the health and the only
thing anyone cares about is making money.
To see how this violates the Hippocratic Oath on several levels lets first
review the modern Hippocratic Oath.
I swear to fulfill, to the best of my
ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.
To see how every part of this covenant
is incompatible with the profit motive we will take it one part at a time. First, I will respect the hard-won scientific
knowledge of those physicians in whose steps I walk, and gladly share such
knowledge as is mine with those who are to follow. Profit motive is incompatible with the
concept of sharing. Therefore,
everything from medicine to vaccines to genes are being patented. Those who hold the patent will not share
their knowledge they will only sell it to the highest bidder. Who in turn will pass this cost on to those
in need of treatment. If you cannot pay
you do not receive treatment which directly violates other parts of the
covenant we will discuss later. The
reason that sharing is part of the covenant is because it is this sharing that
allows health care to progress in ways that provide a healthier and more stable
society. If you take out the sharing
part and replace it with the profit motive then health care moves only in
directions that can be capitalized for profit and not in the best interest of
the patient receiving care or society.
This brings us to the second part: I
will apply, for the benefit of the sick, all measures which are required,
avoiding those twin traps of overtreatment and therapeutic nihilism. The first thing that the profit motive is in
direct conflict with is, “for the benefit of the sick.” In a for-profit health care system, this
becomes for the benefit of the owners of the hospitals, treatment centers,
pharmaceutical companies, patent holders, and shareholders. This then changes all measures that which are
required to, only the measures which the patient or the patient’s insurance
will pay for. Medical care in a
for-profit environment does not avoid the twin traps of overtreatment and
therapeutic nihilism, it exacerbates them.
The more you proscribe the more money you make. This is evident in the pill epidemic in this
country. As for therapeutic nihilism,
this is forced to be a medical professional’s fallback position when a patient
doesn’t or runs out of money. They say,
“There is nothing more we can do. All
the other treatments that are available are expensive.” Which again violates the entire second part
of the covenant.
This brings us to the third part: I
will remember that there is an art to medicine as well as science, and that
warmth, sympathy, and understanding may outweigh the surgeon’s knife or the
chemist drug. Nothing erodes sympathy
and understanding faster or more completely that a focus on the bottom line of
turning a profit. This is why CEO is
such a psychopath laden position. Medical
professionals are put in a no win scenario when they are trying to be
sympathetic while saying “I’m sorry but your insurance doesn’t cover that.”
The fourth part states: I will respect
the privacy of my patients, for their problems are not disclosed to me that the
world may know. Most especially must I
tread with care in matters of life and death.
If it is given to me to save a life, all thanks. But it may also be within my power to take a
life: this awesome responsibility must be faced with great humbleness and
awareness of my own frailty. Above all,
I must not play God. This part of the
oath is about trust between a medical professional and their patient. This trust has been compromised as the public
comes to see medical professionals as salesmen.
This has given rise to such theories as undisclosed cures for illnesses
that require long term treatment and are often fatal. This belief only has a foothold if the
patient feels that the medical professional must consider profitability when
considering how to treat an illness.
The fifth part states: I will remember
that I do not treat a fever chart, a cancerous growth, but a sick human being,
whose illness may affect the person’s family and economic stability. My responsibility includes those related
problems, if I am to adequately care for the sick. If viewing a patient only through the prism
of their medical chart can reduce the medical professional’s empathy towards
them as another human being, then worrying about turning a profit will do this
tenfold. If instead of worrying about
the affect an illness will have on a patient’s economic stability the medical
professional must consider their ability to pay then they are unable to
adequately care for the sick. This is
because not all the options for treatment will be viable, only the ones that
the patient can afford.
The six part strikes directly to the
heart of this matter when it states: I will prevent disease whenever I can, for
prevention is preferable to cure. While
someone cannot be turned away from an emergency room with a life-threatening
illness, they are consistently turned denied preventive medical treatment due
to inability to pay. This is the most
common and obvious violation of the Hippocratic Oath in service of the profit
motive.
The seventh part of the oath states: I
will remember that I remain a member of society, with special obligations to
all my fellow human beings, those of sound mind and body as well as the
infirm. The profit motive trumps any
obligation to other human beings, special or otherwise, as shown above.
The final part of the oath states: If
I do not violate this oath, may I enjoy life and art, respected while I live
and remembered with affection thereafter.
May I always act so as to preserve the finest traditions of my calling
and may I long experience the joy of healing those who seek my help. This part of the oath is violated in its
entirety due to the violation brought on my subservience to the profit motive
as stated in the first seven parts.
