Though the field of medicine during the times of ancient Greeks is very outdated, The Hippocratic Oath is one concept that remains important even to this day. Particularly, there is one line that the general public expects medical professionals to observe: “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” (Tyson). Interestingly, physicians are expected to judge the best interest of the patient in order to do no “harm or injustice,” but how can one person be expected to determine what is best for another person? Of course, any morally sound clinician wants to ensure that the patient receives the best treatment possible, but to accomplish this they must first combine their professional knowledge with the precise knowledge of every patient’s best interests – a feat that is simply impractical.
According to Veatch, in order to implement a treatment while simultaneously respecting the patient’s best interests, a medical professional must adhere to three principles. First, the clinician must ensure that the patient’s medical needs are met; second, the clinician must ensure that the patient’s other non-medical interests are respected; and third, the clinician must be able to uphold various other societal morals and laws even if these may conflict with the patient’s best interests (Holland 320). As Veatch states, all three of these assertions have the possibility of conflicting with each other. For instance, in a case in which a Jehovah’s Witness has a communicable intestinal disease needs to undergo a critical operation, the surgeon explains that the procedure would require an intestinal bacteria transplant (bacteria from the gut of a healthy individual is transplanted in another individual). He offers an alternative treatment regimen that involves cleansing the gut with potent medications, but this has a very high risk of serious irreversible damage. It is in the patient’s best medical interest to undergo the surgery because the risks are lower, yet this would not be in the patient’s best moral interest. The patient may refuse both treatments and may be willing to live with the disease, although she can spread this disease, which is deadly to other individuals. Thus, the clinician is obligated to treat the patient in order to benefit the greater good, yet this violates the patient’s religious interests and/or her medical and autonomic interests. The clinician and the patient could both agree to the alternative treatment, but this encroaches on the patient’s medical interests. The clinician could leave the patient quarantined for the rest of her life, but this would not be in her best medical and autonomic interests. Subsequently, which option is the best for the patient?
In addition to respecting all three of these factors, medical professionals are guessing to determine the patient’s interests. The most efficient way to diminish the amount of guessing which treatment may work best is for the clinician to strengthen their personal relationship with the patient. Unfortunately, even though the doctor can be “generally warm and caring,” patients may still feel as if there is a distance between them and their physician (Chen). Some people have problems that they would not even tell their best friend, let alone a medical professional who might be a stranger to them. To some patients, medical professionals are experts of their body and know what is best for them with regards to treatment. “Some even said they feared retribution by doctors who could ultimately affect their care and how they did” (Chen). An analogous situation is the classroom setting. Some students often feel afraid to question the authority of the teacher, even if it best serves their learning environment, because the teacher has the ultimate say in their grade. In the medical setting, however, the physician has the ultimate say on the patient’s life.
Essentially, it is nearly impossible for a clinician to act fully within the interests of any individual, especially if they do not know the patient on a personal level. In order for the physician to ensure that most of the patient’s needs and desires are met, the doctor-patient relationship must be strengthened. For this to occur, medical professionals should be more personable to patients in order to make them feel comfortable with divulging information. Meanwhile patients should view their physician as just an average human being with whom they can share their opinions and ideas.
Chen, PAULINE W., M.D. “Afraid to Speak Up at the Doctor’s Office.” Editorial. Well. The New York Times, 31 May 2012. Web. 23 Feb. 2014. http://well.blogs.nytimes.com/2012/05/31/afraid-to-speak-up-at-the-doctors-office/?_php=true&_type=blogs&_r=0.
Rosenberg, Jennifer. “Typhoid Mary.” About.com. N.p., n.d. Web. 23 Feb. 2014. http://history1900s.about.com/od/1900s/a/typhoidmary.htm.
Tyson, Peter. “The Hippocratic Oath Today.” NOVA. PBS, 27 Mar. 2001. Web. 21 Feb. 2014. http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html.
Veatch, Robert M. “Abandoning Informed Consent.” Arguing About Bioethics. Ed. Stephen Holland. New York: Routledge, 2012. 318-28. Print.