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Health care providers, doctors and nurses, are bound by codes of ethics that may not be legally binding, but can result in professional ruin if violated. These codes largely have their roots in the ancient Greek physician Hippocrates (460 BC to 371 BC). Known to this day as “the Hippocratic Oath,” the code of ethics that provides the basis for the moral obligations medical providers owe their patients is a direct descendant of that revered historical figure. That oath is considered the precursor to the adage that is commonly attributed to it: First, do no harm. What this means is that the primary moral obligation of a physician to his or her patients is to abstain from any action or recommendation that could make the patient’s condition worse than is already the case. One translation of the original Hippocratic Oath includes that concept as follows: “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.” It is the latter part of that statement that serves as the operational basis for the current-day code of ethics that guides physicians and that is taught to medical students today.
Another fundamental tenet of the ethical framework under the medical profession operates is the concept of doctor-patient confidentiality. Again, the ancient Hippocratic Oath addressed this issue as follows:
“What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.”
The American Medical Association, which serves as the physicians’ governing board (distinct, of course, from the government), and which oversees issues of medical ethics, discusses the issue of doctor-patient confidentiality in its Code of Ethics, specifically, in Section 5:
Opinion 5.05 - Confidentiality
The information disclosed to a physician by a patient should be held in confidence. The patient should feel free to make a full disclosure of information to the physician in order that the physician may most effectively provide needed services. The patient should be able to make this disclosure with the knowledge that the physician will respect the confidential nature of the communication. The physician should not reveal confidential information without the express consent of the patient, subject to certain exceptions which are ethically justified because of overriding considerations.
Comparing the original Hippocratic Oath with the AMA’s current Code of Ethics reveals the extent to which technological evolution has fundamentally transformed the practice of medicine and the extent to which contemporary society has broached subjects scarcely contemplated over two thousand years ago. [links to both the Hippocratic Oath and the AMA Code of Ethics are provided below] Such issues as stem cell research, artificial insemination, genome research and genetic testing, are included in the current code.
The professionalism that is expected of medical providers is instilled in these individuals during their post-graduate academic careers. Students are exposed to the moral conundrums that will inevitably arise during the course of a medical career are, to the extent possible, and they are tested on the moral or ethical issues they can be expected to encounter. In short, patients have a right to expect professionalism from their medical care providers, and that professionalism, beyond the minimal level of competency that should be ensured through the certification processes to which physicians are subjected, includes the principles set forth, first by Hippocrates, and today by the American Medical Association.
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