Hypocritical on the Hippocratic Oath
According to this story, a group of doctors have asked the Kentucky Medical Association to review whether a Kentucky doctor should be permitted to keep his license. Ordinarily, that would not generate news. In this instance, however, the doctor in question is Governor Ernie Fletcher, and the reason for the inquiry is his signing of a death warrant in the case of Thomas Clyde Bowling, convicted of murdering two people in 1990. The doctors claim that the governor's action violates the Hippocratic Oath and Kentucky law (pdf file).
The Hippocratic Oath does not state "First, do no harm," in either its classical or modern form (although the AMA apparently does not endorse any version, but relies instead upon its Code of Ethics), although the sentiments expressed in the oath may reflect that view. As you may notice from the varying versions of the oath, it has changed to no longer prevent a doctor from performing an abortion, so that it now states that performing an abortion is permissible "within an ethical and legal framework." Also notice that the AMA Code of Ethics states, "A physician shall respect the law . . . ."
Section 81 of the Kentucky Constitution states that the governor "shall take care that the laws are faithfully executed." Kentucky law also states that, if a person under a death sentence is mentally incompetent, under the legal definition, the execution is to be stayed until the individual is restored to sanity, then "[t]he execution shall then take place under the warrant of the Governor and at the time designated by him, unless stayed by due process of law." Another statute requires the governor to set the date for execution after appeals have been exhausted. However, the previously mentioned law that the doctors claim has been violated says that "[n]o physician shall be involved in the conduct of an execution except to certify cause of death provided that the condemned is declared dead by another person." And the State Board of Medical Licensure is authorized to adopt a code of ethics, which includes the AMA's code.
These conflicting statutes, if read literally, would prevent a physician from ever being governor in Kentucky, because he would be unable to perform his constitutional duty to see that the laws are faithfully executed. The constitution does not prevent physicians from serving as governor. The courts would most likely rule that signing a death warrant as required by statute is not being "involved in the conduct of an execution" as contemplated by the statutory prohibition, because the governor is not acting in the capacity of a physician.
But let's address the hypocrisy of the doctors using the Hippocratic Oath to justify their complaints. The oath has changed dramatically over the years. In 1928 only 24 percent of medical schools used a form of the oath at graduation ceremonies; today it is almost 100 percent. While use of the oath has increased to near unanimity, some of the more sacred tenets have fallen by the wayside:
"According to a 1993 survey of 150 U.S. and Canadian medical schools, for example, only 14 percent of modern oaths prohibit euthanasia, 11 percent hold convenant with a deity, 8 percent foreswear abortion, and a mere 3 percent forbid sexual contact with patients -- all maxims held sacred in the classical version. . . . Perhaps most telling, while the classical oath calls for 'the opposite' of pleasure and fame for those who transgress the oath, fewer than half of oaths taken today insist the taker be held accountable for keeping the pledge."
Doubtless the doctors opposed to the governor's action would simply respond that the oath has evolved with society into a more "user-friendly" version for modern physicians. Okay. If that is the case, why should the governor be "held accountable for keeping the pledge" when he is not actively practicing medicine, and the offending action was a requirement of his job as chief executive of a state, and when over half of modern oaths do not even make oath-keeping a requirement? And if the doctors are going to use the "do no harm" adage, they should be required to answer for why performing an abortion does no harm. It stops a beating heart.
The Hippocratic Oath does not state "First, do no harm," in either its classical or modern form (although the AMA apparently does not endorse any version, but relies instead upon its Code of Ethics), although the sentiments expressed in the oath may reflect that view. As you may notice from the varying versions of the oath, it has changed to no longer prevent a doctor from performing an abortion, so that it now states that performing an abortion is permissible "within an ethical and legal framework." Also notice that the AMA Code of Ethics states, "A physician shall respect the law . . . ."
Section 81 of the Kentucky Constitution states that the governor "shall take care that the laws are faithfully executed." Kentucky law also states that, if a person under a death sentence is mentally incompetent, under the legal definition, the execution is to be stayed until the individual is restored to sanity, then "[t]he execution shall then take place under the warrant of the Governor and at the time designated by him, unless stayed by due process of law." Another statute requires the governor to set the date for execution after appeals have been exhausted. However, the previously mentioned law that the doctors claim has been violated says that "[n]o physician shall be involved in the conduct of an execution except to certify cause of death provided that the condemned is declared dead by another person." And the State Board of Medical Licensure is authorized to adopt a code of ethics, which includes the AMA's code.
These conflicting statutes, if read literally, would prevent a physician from ever being governor in Kentucky, because he would be unable to perform his constitutional duty to see that the laws are faithfully executed. The constitution does not prevent physicians from serving as governor. The courts would most likely rule that signing a death warrant as required by statute is not being "involved in the conduct of an execution" as contemplated by the statutory prohibition, because the governor is not acting in the capacity of a physician.
But let's address the hypocrisy of the doctors using the Hippocratic Oath to justify their complaints. The oath has changed dramatically over the years. In 1928 only 24 percent of medical schools used a form of the oath at graduation ceremonies; today it is almost 100 percent. While use of the oath has increased to near unanimity, some of the more sacred tenets have fallen by the wayside:
"According to a 1993 survey of 150 U.S. and Canadian medical schools, for example, only 14 percent of modern oaths prohibit euthanasia, 11 percent hold convenant with a deity, 8 percent foreswear abortion, and a mere 3 percent forbid sexual contact with patients -- all maxims held sacred in the classical version. . . . Perhaps most telling, while the classical oath calls for 'the opposite' of pleasure and fame for those who transgress the oath, fewer than half of oaths taken today insist the taker be held accountable for keeping the pledge."
Doubtless the doctors opposed to the governor's action would simply respond that the oath has evolved with society into a more "user-friendly" version for modern physicians. Okay. If that is the case, why should the governor be "held accountable for keeping the pledge" when he is not actively practicing medicine, and the offending action was a requirement of his job as chief executive of a state, and when over half of modern oaths do not even make oath-keeping a requirement? And if the doctors are going to use the "do no harm" adage, they should be required to answer for why performing an abortion does no harm. It stops a beating heart.
posted by Hal | 4:50 PM
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