Posts Tagged ‘Medicine

13
Jul
09

The Hypocritical Hippocratic Oath

Since the time of Ancient Greece, doctors, physicians, healers, and surgeons have sworn the Hippocratic Oath- a solemn vow to “To hold him who has taught me this art as equal… if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art—if they desire to learn it—without fee and covenant… I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice…”.

Or at least, this was the oath that was taken in the time of Hippocrates- to whom the authorship of the oath is attributed. Of course, the modern Hippocratic Oath has changed greatly over the past two and a half millennia. The contemporary text, adapted in 1964, focuses primarily on treating patients not as “a fever chart, [or] a cancerous growth” but as actual people, while also promising respect the privacy of patients and to not “play God”.

So what’s the issue? While the modern version of the Hippocratic Oath makes good points, it lacks certain fundamental elements found in the original oath. While the original oath made doctors obligated to teach each other’s children (if willing to learn) free of charge. Today, learning to become a doctor takes eight years (minimum) and costs a small fortune (medical university is far from cheap). The original oath also ordered doctors to protect their patients from “injustice”. Not disease, not infection, but injustice. This part of the oath is nowhere to be found in later versions.

Now the first section discussed- the section concerning the mutual instruction of the medically aspiring children of fellow doctors- is perhaps understandable. With today’s advances in the fields of medicine, surgery, and pharmaceuticals, it is understandable that this part of the original oath is no longer applicable- after all, there’s only so much any one doctor can know. Nevertheless, one can’t help but imagine what society would be like if doctors- all doctors- were obligated to teach. If anyone willing and diligent enough to learn medicine could study medicine regardless of how rich or poor he was, what would our world look like? Would we have eliminated cancer by now? Would we have the cure for the common cold?

One can really only guess. This is, after all, the great, good, and glorious Capitalist system where a person’s quality of education (or very existence thereof) is determined by the size of his wallet (though the issue of Capitalist/Communist education has been covered in previous posts).

And what of the section concerning a doctor’s duty to protect his patients from injustice? One can easily see why this part would be taken out of newer versions. This is a Capitalist society where medical treatment, like almost everything else, is merely a commodity to be bought and sold. If a patient is dying but cannot afford the treatment that would save him, the doctor is left with an irresolvable quandary. On one hand the doctor has a patient who cannot afford the treatment he needs to live, on the other hand, the laws of Capitalism state that anything is worth what its purchaser will pay for it. So the doctor is presented with a single, impossible option. If he goes along with the “purchase-worth-price-paid” logic, he’d be forced to conclude that since the dying man will not (because he cannot) pay for the treatment, he would rather not live and is therefore suicidal and best committed to a mental institution. Since the man clearly isn’t suicidal, the doctor must either (1) state that the Hippocratic Oath is fundamentally flawed or (2) state that Capitalism is fundamentally flawed. Fortunately, the doctor will not decision. Since, as the advocates of Capitalism would have us believe, Capitalism is completely compatible (perhaps the only system compatible) with justice, the entire situation is a logical paradox and therefore this situation can never exist.

Yeah, right.

Despite [deeply flawed] logic, these situations exist all across the globe, not only for life-or-death situations but almost any medical issue, from cough medicine to prosthetic limbs to brain surgery. The Hippocratic oath, so long as it is practiced in a Capitalist society, will always be a sad hypocrisy. The ugly truth is that Hippocratic oath- even the contemporary Hippocratic oath- will never be able to mesh with Capitalism. There will always be a conflict between ethics and economics, and frankly, if there’s a choice between the two I think it’s pretty obvious which option I’ll take.

And for this reason I submit that we do away with the Capitalist system and replace it with something better. A system where anyone who chooses to be a doctor can be a doctor and have the best medical education available. A system where any person sick, injured, or dying has the opportunity to be treated, and by doctors who are doing so out of the love of their profession and sense of justice and humanity- not self-interest and greed. A system where doctors are never forced to choose between economic feasibility and the Hippocratic oath.

The Capitalist health system is terminally ill, and I believe that this is a physician unable to health itself. Yes, the Capitalist system is in place and has been for a long time, however, as time goes on and the line between justice and injustice becomes more distinct, more pronounced, it is only a matter of time before the people revolt against a system based on flawed-logic and hypocrisy.

26
Jun
09

In Defense of Free Healthcare

One of President Obama’s campaign promises was major healthcare reform and lately, that promise has been repeatedly referenced in the news (primarily on Fox). While opinions on the subject are vary, in general they have tended towards the negative- a common fear voiced is that a “bureaucrat” will be placed between the patient and the doctor (though others have submitted that they’d rather have a bureaucrat between them and their doctors than an insurance company). Conservative icon Glen Beck, for example, argues that this reform will be costly and inefficient in a brief animated video (linked here: http://www.youtube.com/watch?v=MkGhn3LfbyM&feature=related). The video depicts a man who, after being hit on the head by a falling anvil, has to wait six weeks for treatment due to free healthcare. The clip ends with the warning “Offer applies after voting Democrat and not listening to the Glen Beck Program”. Some might call this video a patriotic attempt to maintain an effective and productive system.

I call it propaganda.

What we are actually presented with is an exaggerated and implausible scenario which the creator threatens will happen unless we abstain from the Democrat party and watch his program. Now, purely for the sake of the argument, let’s ignore the insultingly simplistic message and focus on the admonition. Firstly, we are told not to vote Democrat (or risk waiting six weeks for medical attention). People have been voting Democrat for over a century now and no free healthcare system has been implemented. Millions of Americans do not watch the Glen Beck program (some shameless self-advertising), and nationalized healthcare yet to be instated.

“True,” one might argue, “It’s fear-mongering and agitprop, but the core principle is true- free healthcare would be expensive and unproductive.” Now granted, free healthcare would mean that it would take longer to see a doctor however, to say that it would take “six weeks” is simple misrepresentation. Hospitals do have their busy days, but it’s nothing like the crowded mayhem represented by television dramas. In the US, there are hundreds of thousands of public and private hospitals, not to mention an almost countless number of private clinics. Yes, with free healthcare the numbers of people seeking medical attention would skyrocket, but almost assuredly not beyond the country’s capacity to help.

Besides, even if hospitals do become more crowded, how is that a bad thing? More patients don’t mean more disease but more coverage. Those who were unable to afford medical attention before are now able to seek treatment- universal coverage means universal treatment which means a healthier, more productive society (for anyone who isn’t satisfied with the fact that more people are being given medical care).  As for the wait- I’d rather wait six weeks for free medical care than be turned away instantly because I’m not wealthy enough.

And that of course leads us to an important question: why should only the wealthy be healthy? We live in an age of medical miracles that before the 20th century would’ve been inconceivable. We’ve developed vaccines, medicines, and antibiotics to fight off or even cure us of diseases and infections that would otherwise kill us. We’ve created artificial limbs to replace severed ones, and with artificial respirators and pacemakers we can keep humans alive well into their nineties.

If you’re wealthy, that is.

The poor are lucky to benefit from these miracles. If a wealthy man loses an arm, he can purchase an artificial one. If a poor man loses an arm, then there’s nothing that can be done about. If a wealthy woman has complications with her pregnancy, she can hire a midwife, a private physician and so on. If a poor woman has complications with her pregnancy then there’s nothing that can be done about it.

And why is this? When did the wealthy become entitled to longer, healthier lives? Why should the number of green cotton-papers a person has determine when and whether he gets to live or die?

Maybe some of the rich worked hard for their wealth. Maybe some inherited it. Maybe of the poor are poor because they’re lazy. Maybe some were born poor, and for all their hard work remain poor. Sure, the advocates of Capitalism will tell you that the poor can work hard, seize opportunities, move up in life. So if a man works hard his whole life, but his alarm clock’s battery dies and he’s late to work and his co-worker (who works just as hard, but was lucky enough to have a better clock) gets that promotion (and the money for better healthcare) instead of the man who was late, does that mean the late man is somehow less deserving of decent medical attention? Are those who simply missed opportunities (or never had opportunities presented) somehow less-than-human? The Declaration of Independence states that among humanity’s inalienable rights is “the right to life“! How then can we demand that the poor, the wealthy- anyone– pay for life? I defy even the most brutal Capitalist or Social Darwinist to look a person in the eye and tell him that he’s not wealthy enough to deserve good healthcare.

So why would anyone oppose free healthcare? Who in their right mind would trade a little wait for free and universal healthcare?

The answer can be found in another Glen Beck clip (linked here: http://www.youtube.com/watch?v=5mq9zfTEtfI)

The clip, while short, is telling. The show’s guest, Dr. Steve Neeleman- after criticizing America’s “addiction to HMOs”- goes on to describe the virtues of his own company, HealthEquity. What the show doesn’t mention is that HealthEquity is simply another insurance company- and it’s insurance companies that stand to lose the most through universal healthcare. In the interests of full disclosure, it should be mentioned, the subject of the show was Hilary Clinton’s proposed healthcare plan- not free healthcare, but nevertheless the clip serves an excellent example of why insurance companies so staunchly oppose free healthcare. Why would the public pay for something they can get for free? What Glen Beck has done here would be the equivalent of interviewing a horse-and-buggy company owner on the evils of Henry Ford’s Model-T automobile.

In conclusion, yes, free and universal healthcare does have disadvantages. Some taxes would have to be raised and in some places, waiting lines would increase. Nonetheless, the benefits of free healthcare greatly outweigh the disadvantages. Yes, insurance companies would be virtually wiped out, but how does that measure in comparison with the countless lives that could be saved?

It just doesn’t.