In medicine and surgery, traditional medical ethics have been based on the Oath of Hippocrates that has endured through the centuries because its precepts are patient-oriented — namely, that the first consideration of the physician is the needs of the individual patient. Doctors are sworn to do no harm and to advise and do what is in the best interest of their patients; third-party payers, insurers, society and the State are (or should be) secondary considerations.
Abstract — In discussing bioethics and the formulation of neuroethics, the question has arisen as to whether secular humanism should be the sole philosophical guiding light, to the exclusion of any discussion (or even mention) of religious morality, in professional medical ethics. In addition, the question has arisen as to whether freedom or censorship should be part of medical (and neuroscience) journalism.
This is the third volume of the monumental A History of Medicine series by the medical historian and classical scholar Plinio Prioreschi M.D., PhD. A limited number of these books were published, and the reader would be fortunate to find copies of the tomes for less than $350 U.S. dollars. We have already reviewed Volume I: Primitive and Ancient Medicine (2nd edition, 1995) and Volume II: Greek Medicine (2nd edition, 1996).[2,3] We found both of these tomes to be excellent journeys to the history of medicine (and indirectly medical ethics).
In our review of the first volume in this series we introduced the medical scholar Dr. Plinio Prioreschi, the author of this marvelous narrative of the history of medicine, and listed the composition of this series of tomes for the benefit of the readers. We do so again here for the same reason:
A History of Medicine — Volume I: Primitive and Ancient Medicine (2nd edition, 1995); 596 pages
Abstract — The search for longevity, if not for immortality itself, has been as old as recorded history. The great strides made in the standard of living and the advances in scientific medicine, have resulted in unprecedented increases in longevity, concomitant with improved quality of life.
The Story of Medicine by Victor Robinson, M.D. The New Home Library, New York; 1943. Bibliographical Notes, Indexed, 564 pages.
A Prelude to Medical History (1961) by Dr. Félix Martí-Ibáñez (1911-1972) is a short but interesting book on medical history based on a series of lectures to an entering class of medical students, who the author welcomes with excitement and jubilation. Martí-Ibáñez emphasizes such traits as greatness with humility and compassion with learning in medical ethics and the history of medicine. As foundations upon which to build the profession, he lists clinical practice, teaching, and research.
After talking with young neurosurgeons and residents around the world, they often ask "How do I know what I read is the truth?" I answered that question in a recent editorial.(1)
These photos show two physicians who exemplify the rule that if you are seeking ethical guidance, the medical profession is not the place to look. The first is Jack Kevorkian, MD, practitioner of euthanasia and forerunner of the Independent Payment Advisory Board. The second is Ezekiel Emanuel, MD, PhD, advocate of euthanasia, inventor of the Independent Payment Advisory Board, and major architect of ObamaCare.
For several decades, American bioethicists have been providing persuasive arguments for rationing medical care via the theory of the necessary "rational allocation of finite health care resources."(2) More recently, assisted by various sectors of organized medicine, they have developed multiple approaches to justify what they see as the necessary curtailment of services and specialized treatments deemed not medically necessary.
Abstract — In 2013, U.S. President Barack Obama decreed the creation of the Presidential Commission for the Study of Bioethical Issues, as part of his $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) initiative. In the wake of the work of this Commission, the purpose, goals, possible shortcomings, and even dangers are discussed, and the possible impact it may have upon neuroscience ethics (Neuroethics) both in clinical practice as well as scientific research.
This interview resulted in the May 14, 2014 article, "U.S. Experts urge focus on ethics in brain research" by Kerry Sheridan, AFP Correspondent. The article was distributed through the NewsCred Smartwire, Agence France Presse.
Kerry Sheridan, Agence France-Presse (AFP): Hi Dr. Faria, I'm working on a story about calls for consideration of ethics in neuroscience research, and I was wondering if I could interview you about your thoughts on the need for ethical oversight in neuroscience?
With President Obama and his Democratic partisans in the Senate at loggerheads with the Republican-controlled U.S. House of Representatives, an impasse has arisen of troubling proportions. The House, though, has the constitutional power of the purse, and the funding or defunding of the flawed ObamaCare law, unwanted by the vast majority American people, falls within its purview. The House has indeed the right not to fund a calamitous and burdensome law.
When I get a chance I read Viewpoints, the busy electronic version of the Macon Telegraph (MT), which frequently has heated discussions. On September 5, a discussion centered on a MT reader who stated that although in good health at age 75, his doctor would not perform a PSA test or a colonoscopy because "it was not needed" and besides "something else would kill me before colon or prostate cancer does [given his age]."
In his reply to my article, Dr. Miguel Faria, a very fine neurosurgeon and writer, states that it is unethical for physicians “to intrusively ask patients about the presence of guns in the home” and that by so doing, physicians become “snitches” against their own patients.
I agree that if the purpose of asking about guns is solely to report the possession of guns, and that if the physician asks “intrusively” and reports without the patient’s permission and in the absence of an imminent threat, it would be wrong.
It is the free mind and individual responsibility, the principles of the Renaissance that have brought us the wonders of modern health care through the free-market capitalist system and through the inventiveness of the free minds it has raised. It seems we are now going to harness the capitalist engine for rationing....
Medical efforts to prolong the lives of individuals afflicted with serious disease or injury began with primitive medicine, perhaps in the Neolithic Period (8000-3000 B.C.), when we discerned from paleontologic evidence a tendency for primitive men and women to care for the sick and wounded in the shelters provided by the deep caves of Europe.
Physicians classify diseases in a variety of ways. Clinical classifications are often made according to either the suddenness of onset or the expected prognosis. Diseases are considered acute if they develop suddenly and have a short clinical course. Chronic diseases, on the other hand, have a slow onset, indolent course, and long duration. They heal slowly if they improve at all.
Since the time of Hippocrates (460-370 B.C.), the Father of Medicine, physicians have traditionally subscribed to doing no harm and prescribed what is in the best interest of their individual patients; in other words, putting their patients first. This concept is known as individual-based ethics.
The new bioethics movement, on the other hand, subscribes to population-based ethics, in which physicians become obligated to make decisions for their patients in concert with what is in the best interest of society or the state.
In Part I of this article, I discussed a concept that is always on the mind of the socialist planner and that is "social utility." To fully understand this concept one has to understand the socialist philosophy, if it can indeed be called a philosophy — in general, philosophies are analytical.
In this modern era of moral relativism, where one can justify doing nearly anything to anyone, where does one turn for advice on ethics in medicine? Well, right here in the Medical Sentinel, of course, but what about those who have not yet discovered the AAPS?
The Hippocratic Oath — Is it relevant today or does it belong in the scrap heap of history’s discarded relics?
I submit it is relevant today. I submit it is a touchstone that offers a moral compass — an ethical framework — for navigation through these times of crisis. In short, it is the soul of medicine.
For 30 years, I have fought for the maintenance and restoration of medicine based on the Oath and ethics of Hippocrates.
The justification for the independent practice of medicine is so the physician remains beholden to his patients rather than the government or third-party payer.
Dear Dr. Faria,
Your review of Dr. Leo Alexander’s article, “Medical Science Under Dictatorship,” (“Euthanasia, Medical Science, and the Road to Genocide,” Medical Sentinel 1998;3(3):79-83) which [initially] appeared in The New England Journal of Medicine in 1949 was both stimulating and timely.
The October 2, 1996 issue of the Journal of the American Medical Association (JAMA) was devoted to the theme of managed care. I wonder how many people noticed the title of the painting on the front cover? The painting is by Max Beckmann and is titled “The Sinking of The Titanic.” How fitting!
Dear Dr. Faria,
Rapid transition characterizes the ethical revolution
that appears to be at the doorstep of the 21st century.
Dramatic shifts in technology and
communication potential are anticipated.
Increasingly diverse beliefs and value systems,
which make defining a moral framework difficult,
are the order of the day...
Moral Responsibility in the 21st century:
The Status of Ethics in the Professions,
Alumni course (Philosophy A-122),
Summer Session, 1995, Emory University.
Written by two reporters, this book contains a wealth of information about the history and inner workings of the American Medical Association since its founding in 1847. It is divided into two parts. The first covers how the AMA is organized, the history of its development, its ongoing battle against compulsory health insurance, a description of its political action committee (AMPAC), and a discussion of its support for the business ethic. The second covers the AMA's response to health issues including alternative medicine, the tobacco problem, abortion, and the AIDS epidemic.
In A.D. 1212, a Children's Crusade was formed allegedly
to rescue the Holy Sepulcher. Instead, the children were
lured and sold into slavery by unscrupulous and cruel
traders. Thousands of innocent children died of hunger
and disease and from their brutal ordeal. It is said that
the legend of the Pied Piper of Hamelin, who led
the children by the tune of his pipe,
derives from this dreadful affair.
The American Medical Association (AMA) has become a chameleon in its medical ethics. Examples abound. Long after the cancer- and other disease-causing effects of cigarettes were known, the AMA continued to accept money from tobacco, even promoting particular brands.(1) Not until 1981 did the AMA finally sell investments in tobacco stocks under heavy pressure from the news media and anti-tobacco groups of young physicians.