Featured Post

Is the new professionalism and ACP's new ethics really just about following guidelines?

The Charter ( Medical Professionalism in the New Millennium.A Physician's Charter) did not deal with just the important relationship of ...

Monday, September 16, 2019

Just a reminder from Maimonides

Recently I came across comments from a retiring Critical care doc who said that the 1978 novel by Samual Shem entitled "The House of God" no longer seemed so hilarious to him. The attitudes and behind the scene comments of the young house staff reflected a view of patients and medical care far different from what Maimonides had in mine. 

 Maimonides: "May I never see in the patients anything but a fellow creature in pain."

Not as someone who deserves his dyspnea because of cigarette use defying years of advice to quit, not as someone whose ascites is his just due from profligate use of alcohol, not as someone who should not be in this country at all, not as someone who would not be having the myocardial infarction at all if he had done what his doctors told him to do and not as someone who is taking "scarce medical resources" from someone who deserves them more or for whom the treatment could be more cost effective but as a fellow human whose is in need of what physicians spent so many years of their lives preparing themselves to be able to offer.(Not as the "gomers" Shem depicted)

The oath ( Maimonides) should remind us that being face to face with a fellow human in need

..makes judgment beyond the biomedical not only unnecessary but inappropriate.

1 comment:

Nicolas Martin said...

The prevailing view is that the oath is misattributed to Maimonides.

Thomas Szasz wrote a splendid essay on the responsibility and authority of physicians, which appears in his sterling collection, The Theology of Medicine.

"The biologist's or physician's claim that he represents disinterested abstract values — such as mankind, health, or treatment — should be disallowed; and his efforts to balance, and his claim to represent, multiple conflicting interests — such as those of the fetus against the mother or society or of the individual against the family or the state — should be exposed for what they conceal, perhaps his secret loyalty to one of the conflicting parties or his cynical rejection of the interests of both parties in favor of his own self-aggrandizement.

"If we value personal freedom and dignity, we should, in confronting the moral dilemmas of biology, genetics, and medicine, insist that the expert's allegiance to the agents and values he serves be made explicit and that the power inherent in his specialized knowledge and skill not be accepted as justification for his exercising specific controls over those lacking such knowledge and skill.”

“Physicians, especially psychiatrists, have been waging a war on autonomy for more than 200 years.” — T. Szasz