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1. The Hippocratic Oath and the Ethics of Medicine Steven Miles, MD
University of Minnesota
2. Oath -- 400 BC Hippocractic Medicine
Rejected divine explanations for the cause or treatment of disease in favor of empirical, causal observations.
Transformed oral traditions passed in families to recorded observations and clinical experiences shared within a guild.
3. Time Line
4. The Cutting Insertion
5. Oaths Ethics?Questions Who is the physician?
What is the physician committed to?
Who is the physician accountable to?
6. Who is the physician?
7. Opening of Oath: An invocation?... I swear by Apollo the Physician and by Asclepius and by Hygieia and Panacea and by all the gods as well as goddesses, making them judges [witnesses], to bring the following oath ? to fulfillment, in accordance with my power and my judgment;
8. ? or does it proclaim geneology? ?Is there a man who has not heard of me?Amphitryon of Argos, son of Alcaeus, grandson of Perseus, and father of Heracles. I have lived here in Thebes ever since the crop of Sown Men sprang full grown out of the Earth.?
From Heracles by Euripides
9. The Family of Medicine I(Medicine born of love and grief)
10. Apollo: Prophecy & Prognosis Apollo
God of Reason
God of Prophecy
Oracle at Delphi Physicians
Reason- Natural Cause and Effect:
Points to cause, diagnosis, and treatment.
11. Prometheus (Foresight) A titan who gave humans fire and creativity to invent medicines and imagine a prognosis.
To prevent despair at foreseeing death in a person who was dying.
Prom: I stopped mortals from foreseeing doom.
Chorus: What cure did you discover for that sickness?
Prom: I sowed in them blind hope.
Aeschylus. Prometheus Bound
12. The Family of Medicine II
13. Pindar?s Verdict on Asclepius Still, even wisdom yields to hope of profit. And gold induced no less than he [Asclepius] to try to resur-rect a man whom death already had imprisoned?. We must seek from deity the things that fit our mortal hearts, keeping our cond-ition and our destiny in mind. My vital being, do not seek immortal life; exhaust, instead, all possibility. Pindar. Pythian Odes 3-63.
14. What does the Apollo Genesis Story of Medicine Say? The passion to heal arises from love and grief.
Physicians must accept mortality as a boundary for moral work.
The names of Asclepius and Epione say that healing is not a war but a gentle rebalancing to path to health.
15. The Family of Medicine III
16. The Family of Medicine IV
17. What is the physician committed to?
21. What Does the Physician Promise to the Patient? 1
22. What Does the Physician Promise to the Patient? 2
23. Who are Physicians Accountable to? If I render this oath fulfilled, and if I do not blur and confound it may it be to me to enjoy the benefits both of life and of techne (art and science), being held in good repute among all human beings for time eternal.
If, however, I transgress and perjure myself, the opposite of these.
24. Oath?s Vision
25. Summary Oath conforms to the medical practice and rhetoric of Classic Greece.
Roles: education, compiling knowledge, and treatment.
Ethics: beneficence and on avoiding injustice in public and clinical spheres.
Progressive and historically accountable rather than deistically accountable.
26. Steven Miles MDmiles001@umn.edu