Doctors take the Hippocratic Oath too seriously. − Ezekiel Emanuel
Ezekiel Emanuel, MD, PhD is the brother of Rahm Emanuel, former chief of staff to Pres. Obama and mayor of Chicago. Ezekiel Emanuel was trained, as I was, as a medical oncologist, but − to put it gently − our paths diverged.
I spent 25 years in patient care, teaching, and research, mainly at Los Angeles County-University of Southern California Medical Center. Based on my long experience caring for patients in a government-run setting, I became dubious about extending government-run care to everyone. Based on my brief experience in the Army Reserve, I became dedicated to the well-being of those who risk their lives to protect us. Based on my religious values, I became convinced that all human life is sacred.
Emanuel went on to get a PhD in political philosophy from Harvard. He became Director of Clinical Bioethics at the National Institutes of Health, as well as advisor to Pres. Obama on health-care policy. What the basis for his values may be I do not know. But he formed opinions very different from mine. And because of his and his brother’s positions, his views strongly influenced ObamaCare.
Here is a sample of Emanuel’s views:
Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-year-olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.
That is, ration care for the elderly, but call it something else.
Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.
That is, ration care for the mentally challenged, but call it something else.
If you think I am exaggerating, read “Deadly Doctors” by Betsy McCaughey. To reverse Kipling’s observation, if you can remain calm when those around you are frightened, maybe you just don’t understand the situation.
This brings us to the subject of oaths. Emanuel proclaims:
This culture is further reinforced by a unique understanding of professional obligations, specifically, the Hippocratic Oath’s admonition to “use my power to help the sick to the best of my ability and judgment” as an imperative to do everything for the patient regardless of cost or effect on others.
Emanuel’s concerns may be outdated. Only one American medical school still administers the Hippocratic Oath. They use a variety of other oaths, which refer to “humanity” but give less attention to the individual patient. Some graduates make up their own oath. It is easy to promise to carry out your own ideas. It is entirely different to promise to live by the ideals of a noble and ancient calling.
When I graduated years ago, we all took the original Hippocratic Oath. I framed my copy and hung it on my office wall. It is a bit yellowed now, but I can still read it clearly. In fact, I actually do read it from time to time, which is more than I can say for many of my colleagues.
I believe the chief cause of the Oath’s demise is its prohibition of abortion. But it also prohibits assisted suicide and euthanasia. Abolishing the first prohibition weakened the others. I do not believe this was accidental.
Question: Of all professions in Germany, which had the highest percent of members of the Nazi Party? (1) Army officers. (2) Engineers. (3) Lawyers. (4) Physicians. Answer: (4). When leading doctors support late-term abortion, assisted suicide, euthanasia, destruction of human embryos to obtain stem cells, or government-run health care, remember not to expect moral leadership from the medical profession. You will be disappointed.
The term “life unworthy of life” was used by the Nazis, but it originated before anyone heard of Hitler. Nazism was a seed that fell on soil that had already been fertilized by the manure of seeing human beings not as having intrinsic worth because they are created in God’s image, but as having worth only if they are economically useful to the state. If health care must be “cost-effective,” this point becomes vitally important.
The Nazi euthanasia program utilized drugs, then gas, and was the physical and psychological prelude to the Holocaust. It was opposed so strongly by Catholic and Protestant churches that it was stopped, though it continued unofficially. Sadly, there was no organized opposition by physicians.
The father of Baby Knauer, a disabled child who was the first person “euthanized” by the Nazis, stated, “Later, we could have other children, handsome and healthy, of whom the Reich could be proud.” We aren’t there yet, but if we are not careful, we will be on our way to eliminating “useless eaters” and making the Reich proud.
Perhaps 3000 to 5000 partial-birth abortions are performed annually. Dehydration to death of the brain-damaged is becoming accepted practice in America. Ethicist Fred Rosner, MD protests that this “…attacks the very foundation of medicine as a profession.”
To me, this is a crucial problem. To others, it may be an advantage. If physicians are no longer independent professionals, exercising their best judgment for the patient’s benefit, but become mere employees of the state, surely there will be fewer problems for administrators – regardless of what they are administering.
Yes, I took the Hippocratic Oath, and I still believe myself to be bound by it. I took the Oath to God, and He has not absolved me from it. I also took the Oath of Allegiance when I was commissioned in the Army Reserve, and again when I was commissioned in the Public Health Service. You know − the oath to defend the Constitution against all enemies, foreign or domestic.
• Does the Constitution empower the federal government to control the health care − and hence the lives − of all Americans?
• Does the Constitution empower the federal government to force physicians, psychologists, and other health-care providers to report private information on diagnoses and treatments? This violates the confidentiality requirements of the Hippocratic Oath.
• Does the Constitution empower the federal government to take over health insurance, and to hobble private insurance with so many restrictions as to make it unobtainable?
• Does the Constitution empower the federal government to force physicians, nurses, and others to participate in procedures they find morally objectionable (abortion, euthanasia, etc.) or leave their profession?
• Does the Constitution empower the federal government to decide who is worthy to remain alive, and who is not?
• Does the Constitution empower the federal government to tell old or disabled people when to die?
Is all this about health care, or is it really about ruling us by holding the power of life and death over our heads? Are those who are striving to do these things supporters of the Constitution, or do they want to abolish the Constitution − but under the guise of “caring” for people? Are they friends who want to use different methods, or domestic enemies who want to achieve different goals?
Legally, I was absolved from the Oath of Allegiance when I was discharged from the service. But morally, I still believe myself bound by it. I feel an unbreakable obligation to defend the Constitution against all enemies, foreign or domestic. Contrary to the advice of “experts,” I take the Hippocratic Oath and the Oath of Allegiance very seriously. Extremely seriously. Deadly seriously. And I’m not the only one.
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