NCPA - National Center for Policy Analysis

Physicians Groups Seek New Hippocratic Oath

February 13, 2002

Three influential medical organizations in the United States and Europe have published guiding principles for physicians worldwide in the Lancet and Annals of Internal Medicine.

The physicians' charter, a new Hippocratic oath of sorts, includes three fundamental principles and 10 professional responsibilities. The principles are: the primacy of patients' welfare, patients' autonomy and social justice.

The professional responsibilities involve such concepts as a commitment to professional competence, increasing scientific knowledge and improving access to equitable health care.

Thus "social justice" in the context of health care is the just distribution of finite care resources regardless of financial or other considerations. It also entails "promotion of public health and preventive medicine, as well as public advocacy...."

Some physicians are criticizing the document for introducing the concept that physicians are obligated to consider not only the interests of the individual patient, but the requirements of society.

They say it is really a call for equal outcomes between social classes and ethnic groups. Applied worldwide this would mean a massive reallocation of health care resources to the developing world, where there are few resources and more unmet needs. This would require eliminating resource-intensive medicine -- such as transplants and cardiac surgery -- in the developed world.

Critics conclude that the charter is a political document that equates inequality with injustice, and would obligate physicians to become activists.

Source: "Medial Professionalism in the New Millennium: a Physicians' Charter," Lancet, February 9, 2002; Theodore Dalrymple, "By Apollo! This Oath Is Dangerous: Hippocrates's New Code Will Force Doctors To Promote A Political Agenda," National Post (Canada), February 7, 2002.


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