HIPPOCRATIC OATH AND THE MODERN INDIAN DOCTOR

Following is taken from Wikipedia:
The Hippocratic Oath is an oath historically taken by doctors and other healthcare professionals swearing to practice medicine ethically. It is widely believed to have been written by Hippocrates, often regarded as the father of western medicine, or by one of his students.
A widely used modern version of the traditional oath was penned in 1964 by Dr. Louis Lasagna, former Principal of the Sackler School of Graduate Biomedical Sciences and Academic Dean of the School of Medicine at Tufts University:
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 [that] 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 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 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.
The most significant ommission from the original is:

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

There is, therefore, nothing in the modern version of Hippocrates Oath to directly remind the modern doctor that all seductions (of money and sex, for example) are to be avoided. There is, however, a pointer towards his social responsibility.
 Lets consider a few things, which were in the news recently:
  • The first one is that the doctors specify to patients from where to get medicines so that they would get a commission from the chemists.
  • The doctors ask a series of expensive tests to be done such as MRI, CT, blood tests and others by specifying where or in which lab these are to be done because they receive their cut from these labs.
  • Mumbai administration had to remind an elite hospital that the land for making the hospital was given to the hospital on subsidised rates on the understanding that at least 25 percent of the patients being treated in the hospital would be poor; however, the hospital had been turning away all poor patients.
  • After completing MBBS the doctors are required to serve in the rural areas. However, a large percentage of them circumvent this provision by hook or by crook.
Lets also take into consideration the exorbitant fees that some of the doctors charge. If, after all this, you reach the conclusion that medicine or being a doctor is now big business, you may not be far from the truth. There are many reasons for this:
  • It was in the news recently that to obtain a Post Graduation seat in a medical college in Navi Mumbai a candidate had to dish out Rupees 1.4 Crores.
  • Many of the medical insttritutions are either owned by the powerful like the politicians or they have substantial representation in the board of directors of the institutions either directly or through their kith and kin.
  • Most payments to the doctors are made in cash. Indeed, even the labs insist on cash payment so that no trace of payments can be made. Hence, in the Income Tax returns most doctors and chemists and labs show only a miniscule percentage of their actual earnings. It is so easy to insist on cheque payments but then even the patients or their relatives don’t insist on it lest the doctors should spoil their cases in anger. It is, afterall, many a times, matter of life and death.
  • As with the lawyers, the doctors often get away with this arrangement since everyone wants to keep the doctors on their right side. These include the authorities responsible for keeping tabs on their illegal earnings.

We have a situation now, for the first time after independence, whence Anna Hazare’s movement has given hope to the people of the country. Should we not try to break this vicious cycle of doctors spending astronomical sums of money to obtain their degrees and then fleecing the patients to recover such monies?

 

© 2011 – 2016, Sunbyanyname. All rights reserved.

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9 Comments

  1. Hello, Sunbyanyname. My name is Stan. I recently started following your blog.

    I wrote a paper several years back that compared Hippocratic oaths over the centuries, including Lasagna’s. My paper focused on the different allegiances to which versions of the oath have been sworn…Aesculapius, Jesus, Allah, The Communist Party, Secular Humanist Ideal…and the way in which the ethical allegiance of the civilization to which the oath taker belonged shaped the things they swore to do.

    Anyways, I enjoyed some of your comments on the state of medicine in parts of the world with which I am less familiar. I live in America, where we have our own Hippocratic anomalies.

    You might enjoy some of the posts I’ve written that focus on or include Hippocrates:

    http://stansgreatbooksblog.blogspot.com/search/label/Hippocrates

  2. Well said. But the breed of healthcare providers has become so money-minded, not without reason, that it is not going to penetrate their thick skins. I have recently started visiting your blog and found it interesting enough to become a subscriber. I would love to have your reactions to my post on this subject ‘Oh Doctor’ at http://wp.me/p10wLZ-nQ

  3. Hi

    Great post! Some of the doctors in India are very competent, a fact I have seen through some recent experiences in the family. But the practice of fleecing their patients is gaining prominence and one lame excuse they have is the fees they paid to get the degree. I cant bring myself to accept that as a reason. Like many other professions, we dont have doctors in the field as they are passionate about being doctors. They became docs because its like a money-yielding-tree kind of a profession. That simply shows!

    1. You are a serious and thinking reader; else on the Indiablogger I keep coming across those who write just one line and call it a post! I entirely agree with your inference. When I was in the Navy, I was somewhat protected from the avarice of the doctors. However, now that I am on the civvie street, I do come across doctors who are busily writing a battery of expensive tests to be done even when you are relating your problem! And in case such a doctor has asked for an MRI to be done, and you dig out a recent one from your bag, he ignores it to say “It isn’t all that clear. You should get one from Alpha Diagnostics”. I am writing this from personal experience.

    2. Very right! What to do for this kind of illness , on doctor’s mind? Nationalize the medical education itself?Can’t.

      About the corporate hospitals, you enter at your own peril.

      My G.P. who I know since 30 years, insists that I eat all sorts of big list, that too from his own next door pharmacist.

      Now,I question him , his medicine, and his way of treating our illness, with overdose. But what about all those who throng his clinic?

      Sad.

    3. What a super expression: a mental illness suffered by the doctor. I guess, you have hit the nail on the head, Vetrimagal, by saying that if the docs are so greedy, why do we still throng to them? Indeed, that explains the reason for their greed and arrogance: “if you don’t come to me, there are a hundred others.”

      However, I am confident, there would still be dawn after the dark night.

  4. The system of oath taking has no relevance today be it in Educational Institutions, Parliament or in Medical field. All that is left is just ‘Killing field’! All that a Doctor should have is ‘Clear Consciousness’.
    I feel instead of prescribing medicines of a particular company, doctor should prescribe the formula or contents and choice be left to buyer when he goes to the medical store.

    1. Thank you for your very relevant and detailed remarks. Do you think the nation is losing its soul in its citizens’ pursuit for all that money can buy and bring? I think a major course correction is required. The starting point for that is major soul-searching by all of us.