Hello fellow Netizens!
As a medical student, this article is more personal to me than most of the others that I have written so far. It was inspired by a major case that dominated news headlines for some time recently: Food and Drug Administration v. Alliance for Hippocratic Medicine (a.k.a the mifepristone case). While most of our attention was focused on charged issues (abortion and reproductive health, challenges to the FDA’s authority), I was intrigued by the actual respondents for the case: the Alliance for Hippocratic Medicine. My research into them has led me to look more closely at the medical profession and what medical ethics looks like in the United States.
The Alliance for Hippocratic Medicine: Who Are They?
The Alliance for Hippocratic Medicine (AHM) is an organization that reports to be comprised of medical professionals who believe and uphold the Hippocratic Oath. According to their website, their mission statement is the following:
“The Alliance for Hippocratic Medicine (AHM) upholds and promotes the fundamental principles of Hippocratic medicine. These principles include protecting the vulnerable at the beginning and end of life, seeking the ultimate good for the patient with compassion and moral integrity, and providing healthcare with the highest standards of excellence based on medical science.”
The Alliance for Hippocratic Medicine
You may be saying to yourself: “Well, they seem legit to me.” At first glance, the group does look innocent enough; they follow the Hippocratic Oath after all right? The truth of the matter is, the Hippocratic Oath (with all of its history and credibility in the public imagination) is not what it seems.
The Hippocratic Oath: Problematic?
When I became a medical student, I was excited to put on my white coat and take the oath to become a physician. I never really thought much about what the oath said, other than it was meant to make all doctors bound to a code of ethical guidelines when treating patients. To a degree, I was not wrong: the intention of the Hippocratic Oath and all future (alternative) oaths that students take in their respective schools was to bind medical professionals to a common set of standards for the art and practice of healing. The Hippocratic Oath in particular, however, has very controversial portions in its text that may surprise modern people unfamiliar with its content. Probably one of the more infamous lines (and the one that organizations like the AHM champion) is the following:
“I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.”
Translation of the Hippocratic Oath, sourced from the NIH
With this in mind, it makes more sense why AHM pushed a case with the FDA on mifepristone. To clarify, mifepristone (in combination with misoprostol) acts as an abortifacient and is used to terminate pregnancies up to 10 weeks of gestation. Physicians who prescribe to the Hippocratic Oath use it as justification for their argument to ban mifepristone’s use within the United States (among other reasons that will be discussed in a future article).
As a side note, you may have also figured out that the Hippocratic Oath bans doctors from performing both physician-assisted deaths and euthanasia. This issue in itself is ethically complex and will also be tackled in a separate article; needless to say, the Oath makes modern medical practices more difficult than it has to be by pressing physicians to follow sets of moral rules that are highly outdated at best, and harmful at worst. This is why many medical schools in the United States have ditched the Oath all together; one study from 2018 found that of the US and Canadian schools that they surveyed, none used the traditional Hippocratic Oath. I personally did not recite the Hippocratic Oath during my ceremony and instead used a modernized oath.
Medical Ethics In America: Why It Matters to You?
At last, you may be thinking, the most important question: Why should I care?
For medical students like myself, along will all members of the physician profession, ethics is what holds the field accountable for its actions when it comes to patient safety. The oaths that we all pledge when entering medical school is a symbolic contract between ourselves and the communities we will eventually be serving in.
For Netizens like yourselves, you would probably prefer to see a doctor in your office with ethical standards rather than one without. For a real-world example, the opioid epidemic that ravaged parts of the United States was (in part) exacerbated by some physicians who prescribed medications with cash over health in mind. These “pill-mill” doctors clearly violated one of the most important pillars of medical ethics: non maleficence, or the concept of doing no intentional harm to patients. I cannot stress enough that these doctors are few and far in between; a vast majority of doctors practice medicine with good and ethical intentions. However, everyone is entitled to proper healthcare and a physician who upholds high standards in their medical practice. What those standards are will depend on the physician and what training they received, which is why even small items like what oaths they recite matters significantly in what kind of care you are able to get as a patient.
If you are interested to learn more about the history of Western Medicine (and to read a fully translated version of the Hippocratic Oath), visit this website created by the NIH.
For more information on the current Supreme Court case between the FDA and AHM, see the following:
Basics for the Case: Oyez – Food and Drug Administration v. Alliance for Hippocratic Medicine
AP: Supreme Court seems likely to preserve access to the abortion medication mifepristone
CBS: Supreme Court seems poised to reject abortion pill challenge after arguments over FDA actions
CNN: Takeaways from the Supreme Court arguments over the abortion drug mifepristone
Until next time, fellow Netizens!
Featured Image: See page for author, CC BY 4.0 https://creativecommons.org/licenses/by/4.0, via Wikimedia Commons
Disclaimer: This article reflects the author’s own opinions and statements. They do not reflect the opinions or stances of any organization affiliated with the author.
