On PM Lee's interpretation of the Hippocratic Oath
By Guest Writer (Twasher) on 06 Oct 2007 11:19 PM
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The author and her articles can be found at the blog "The Rot Within".

There has recently been some controversy over the fact that Singapore hospitals have been giving medical treatment to ailing leaders of the Burmese junta. 1, 2 Critics object to Singapore's giving medical aid to the perpetrators of atrocities in Burma. In an interview with CNN, Lee Hsien Loong responded to this criticism thus:

I think we have to decide whether we're trying to influence the policy of a government or whether you want to do petty indignities to individuals, which is really against human nature.

Somebody who is sick, he wants to come to Singapore, he needs treatment and you're telling me that I shouldn't treat him because he is not a good man? It goes against the Hippocratic oath of doctors.3

First off, it should be noted that the first sentence in the quote is quite inaccurate. We do not have to decide between influencing the policy of a government and doing petty indignities to individuals, assuming for the sake of argument that refusing medical treatment to the likes of Than Shwe would be doing a 'petty indignity'. The two options are not mutually exclusive. We can refuse medical treatment to Burmese leaders while influencing the policy of a government. It is probable that if we hasten the passings of Than Shwe and Soe Win by refusing them medical treatment, that this will have an effect on Burmese government policy. It is rare that a major change in a country's leadership does not result in any changes in policy.

But the main thrust of Lee's response, his citation of the Hippocratic oath, is also problematic. The Hippocratic oath, in either its classical or a commonly used modern form, does not say anything about doctors being obliged to help any ailing person who requests their assistance. The closest it comes to stating such an obligation is in the following excerpts:

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.4
(Classical version, trans. Ludwig Edelstein)
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.5
(A modern version written by Louis Lasagna, used in some medical schools today)

In taking either of these oaths, doctors promise to apply certain measures for the benefit of the sick. But this simply means that as long as they apply measures for the benefit of some sick people, they have fulfilled the conditions of the oath. They do not need to apply those measures to all sick people, nor is there anything in the oath stating that they have to apply those measures to all sick people who request their assistance. Unless Lee has in mind a significantly different version or interpretation of the Hippocratic oath, it is safe to say that the Hippocratic oath does not oblige Singapore doctors to give medical assistance to Burmese political leaders.

References:
1. "Burmese PM in Singapore hospital". BBC News, 21 March 2007.
2. "Wife and daughter of Burmese PM 'have left the country'". Times Online, 1 October 2007.
3. Wong Siew Ying, "Sanctions against Myanmar will be counter-productive: PM Lee". Channel News Asia, 5 October 2007.
4. The Hippocratic Oath, trans. L. Edelstein,
5. L. Lasagna, The Hippocratic Oath (Modern Version).

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Comments (2)

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WANG:

Twasher

Interesting analysis, would your comments/perspective be thus also applicable to any patients who were criminal or have criminal records who happens to visit a private 24hr clinic or any private clinic in Singapore irrrespective of their conditions.

Regards
WANG

Perhaps the Physician's Oath of the Declaration of Geneva (1948) by the World Medical Association might prove more helpful:

"...I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient..."

WANG raises a valid point: If a so-called physician denies treatment to those he deems vile, where is the line drawn?

Is it drawn when the patient has committed a capital crime? Or when the patient is guilty of felony?

Or perhaps when the misdemeanour is of particular objection to some?

Or maybe when he dislikes something about the way the prospective patient looks?

It is a slippery slope. And it takes but one step into that righteous slickness.

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