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Allegiance to the Hippocratic Oath

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`IT is not immoral for a physician to assist in the rational suicide of a terminally ill person,'' said a panel of 12 doctors in the latest New England Journal of Medicine. But history warns us that euthanasia should not be performed by physicians. No matter how pure the sympathetic motives of any physician who does not want to see patients suffer a long and painful death, physicians who freely agree to help with a little killing will not long be able to resist society's demand for more and more killing. For there is no limit to the number of social and human problems that can be ``solved'' by killing. Even today, societies around the world openly practice capital punishment, torture of political dissidents, genocide, and infanticide.

In a provocative explanation of how modern medicine emerged from primitive magic, anthropologist Margaret Mead noted that in all primitive cultures, destructive and protective magic are always associated in the same person. The witch doctor or shaman may come to heal with a potion, or to kill with a poison. The same dual nature of medicine appears in Plato's ``Republic,'' where physicians are expected both to heal society's philosopher guardians and kill defective newborns or maimed athletes.

Only with Hippocrates did healers categorically renounce killing. The disciples of Hippocrates rejected not just some killing, but all killing; no abortion, no assisted suicide, no deadly drug, no killing at all.

The Hippocratic oath finally permitted patients to trust physicians without reservation. And it finally permitted physicians to practice their art without yielding to society's incessant pressure to involve them in lethal but socially useful activities.

A chilling example of what can happen when physicians agree to do a little killing occurred in the 1920s and '30s in Germany, then the most humane and scientifically advanced medical community the world had ever known. At first, German physicians accepted only the thesis expressed in a monograph published in 1920, ``On the Destruction of Life Unworthy to be Lived'': ``Not granting release by gentle death to the incurable who long for it; this is no longer sympathy, but rather its opposite.'' This is the same impulse that many doctors today feel when confronted by a terminally ill patient who wants to be free of suffering.


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