Physician Oaths, Then & Now

Hippocrates_rubens

It is well worth examining the changes over time in the oaths physicians swear to, especially as we have entered an era when the term “doctor” is being applied to people whose goal is not to preserve life and to heal, but to kill and inflict injury. The World Medical Association is also decided to revamp to Declaration of Geneva, which is the modern-day Hippocratic Oath.

Nobody knows what the new Declaration will be, but we have clues in the changes to the Hippocratic oath, and in considering the politicization of medicine. I do not mean this review to be exhaustive.

The original Hippocratic oath opened thusly:

I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment.

This had, in places, morphed to “I swear by God” or some variant. In the original oath is also the clause “I will comport myself and use my knowledge in a godly manner.” A modern version of that oath, written in 1964, began “I swear to fulfill, to the best of my ability and judgment, this covenant”; buried in another clause are the words “Above all, I must not play at God.” The Declaration of Geneva, written in 1948, and currently perhaps the most used document, begins, “I SOLEMNLY PLEDGE to consecrate my life to the service of humanity”.

Swearing an oath to be under the watchful eye and (ultimate) judgement of God or even of the gods is a terrible and awesome burden. Promising to be godly recognizes and puts supreme authority above the physician; it is humbling. Tepid admonitions not to “play God” imply a man could be God but shouldn’t, or at least not too often.

The modern documents are not quite oaths, merely promises a man makes to himself. How so? By 1948 the words covenant consecrate, which are in the modern documents, had become what David Stove called a “smile words”. They used to mean “a solemn (or sacred) compact” and “to set apart as a sacred office”, but now they only mean “believed by somebody to be a solemn compact” and “believed by somebody to be a sacred office.” Believed by somebody, not me, that is. The words have been drained of force; thus, those that use the words know they aren’t sacrificing much freedom. Certainly the modern “oaths” are more like guidelines than pledging one’s soul.

The second clause of the original:

I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master’s children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else.

In Geneva this changes to the brief “I WILL GIVE to my teachers the respect and gratitude that is their due”, an amusing difference. We have moved from “I will teach them my art without reward or agreement” to “The median education debt for medical school shall be $170,000, and that is before residency.”

The most consequential discords are in the value of life. Relevant clauses from the original oath:

With regard to healing the sick…I will take care that they suffer no hurt or damage.

Nor shall any man’s entreaty prevail upon me to administer poison to anyone; neither will I counsel any man to do so. Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child.

“Doctors” now routinely kill the lives inside would-be mothers, and, in some countries legally and elsewhere illegally, even kill their patients. Not accidentally; on purpose and by design. “Doctors” also now—for a fee—mutilate patients or cause them other harm, usually at the patients’ request but not always (parents might request mutilation for a child, or relatives for an unconscious patient).

The 1964 contract excised the original hard proscriptions, and in their place, or anyway added,

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will prevent disease whenever I can, for prevention is preferable to cure.

These are an enormous changes! Before, patients sought out physicians when they were ill. Now, physicians must seek out patients even when they are in health. Physicians have become authorities over patients, instead of the opposite. Consider that the actions to prevent lack of health are limitless, thus theoretically the power physicians gave to themselves is also without limit.

In Geneva, the cautions against causing death and injury are these:

THE HEALTH OF MY PATIENT will be my first consideration;

I WILL MAINTAIN the utmost respect for human life;

These are banalities, as is obvious in cultures which preach that abortion, euthanasia, and mutilation are “rights”. Since it is impossible to have a right without a responsibility, a “right” to a killing requires the responsibility on someone to do the killing. This is why governments are requiring doctors to perform “services” such as killing and maiming. Apropos is this article (with implied affirmative answer: “Could it soon be illegal for doctors to believe in male and female?

Significantly absent in Geneva are any proscriptions or cautions against directly harming any person. Yet in the modified Hippocrates is found this bizarre passage: “But it may also be within my power to take a life; this awesome responsibility must be faced with great humility and awareness of my own frailty.” The “doctors” who perform abortions do not think of those that they are killing as “patients”; instead the would-be mothers are “clients” who receive a “service”, much like a man at a garage has a scratch buffed out on his car. Doctors who kill patients at the patients’ request do, of course, consider those they kill as patients, but only in a brutal, utilitarian, which is to say pagan, sense. It’s not patient lives which are to be cherished, but (states of) “health.”

Absent from the original Hippocrates are specific political statements. Not so in the 1964 version, which contains this: “I will remember that I remain a member of society, with special obligations to all my fellow human beings”. Now this doesn’t seem much, until these passages from Geneva (which were inserted well after 1964) are considered:

I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;

Both statements reek with politics. The first clause is entirely superfluous, medically speaking. And it’s nonsensical practically. Does blindness to “sexual orientation” include ignoring rapists, pedophiles, those attracted to goats, cadavers, fairground rides or God knows what all else? What could “or any other factor” possibly mean? “Rights” is so abused that we needn’t discuss it. “Civil liberties” is the Orwellian phrase that means “uncivil restrictions”, things like mandated commerce and forced assembly. A male patient pretending to be a woman (and possibly maimed by another “doctor” in an attempt to resemble one) and insist it is his “civil right” to be treated as a woman, which is to make medicine a farce.

We can reliably forecast more inversions in the changes to the Declaration of Geneva. According to Urban Wiesing and Ramin Parsa-Pars, in a Bioethics article discussing the World Medical Association’s proposed modifications, “respect for patient self-determination has been established as one of the most important principles of medical ethics. However, it is not mentioned in the Declaration of Geneva.” Meaning it will be.

Not only will health be a “right”, but so will whatever body state a patient wishes. And, as above, since rights implies responsibilities, patient “self-determination” will be forced upon doctors—and upon you, too.

Summary Against Modern Thought: Creation Is Not Change From Something To Something

This may be proved in three ways. The first...
This may be proved in three ways. The first…
See the first post in this series for an explanation and guide of our tour of Summa Contra Gentiles. All posts are under the category SAMT.

Previous post.

Creation-from-nothing is not the change of one thing into another in the way most physicists who write on the subject say it is (Larry Krauss is a good example). Creation is not a fashioning, for that implies making something out of something. Creation is the strangest thing you can think of. And, as always, review! These arguments not isolated from what came before.

Chapter 17 That creation is neither movement nor change (alternate translation)

[1] HAVING proved the foregoing, it is evident that God’s action, which is without prejacent matter and is called creation, is neither movement nor change, properly speaking.

[2] For all movement or change is the action of that which is in potentiality as such. Now in this action there preexists nothing in potentiality to receive the action, as we have proved. Therefore it is neither movement nor change.

Notes He means in the act of creation there is no movement or change. Nothing to something is not a change in something. No potentiality is being actualized. This is the key.

[3] Again. The extremes of a movement or change are included in the same order: either because they come under one genus, as contraries, for instance in the movement of growth and alteration, and when a thing is carried from one place to another; or because they have one potentiality of matter in common, as privation and form in generation and corruption. But neither of these applies to creation: for it admits of no potentiality, nor of anything of the same genus that may be presupposed to creation, as we have proved. Therefore there is neither movement nor change therein.

Notes In the state of Nothing, that lack of something is not a privation, i.e. an “evil” (lack of good, or evil, is a privation, as we discovered before). Nothing is not an absence. It is non-existence. Study Thomas’s description; it is technically correct. But as creatures embedded in material existence, Nothing is hard to think of, perhaps impossible to fully grasp.

[4] Further. In every change or movement there must be something that is conditioned otherwise now and before: since the very name of change shows this. But when the whole substance of a thing is brought into being, there can be no same thing that is conditioned in one way and in another, for it would not be produced, but presupposed to production. Therefore creation is not a change.

[5] Further. Movement and change must needs precede that which is made by change or movement: because having been made is the beginning of rest and the term of movement. Wherefore all change must be movement or the term of a movement that is successive. For this reason, what is being made, is not: for as long as movement lasts, something is being made and is not: whereas in the term itself of movement, wherein rest begins, no longer is a thing being made, but it has been made. Now in creation this is impossible: for if creation preceded as movement or change, it would necessarily presuppose a subject, and this is contrary to the nature of creation. Therefore creation is neither movement nor change.

Notes It’s not easy to see, but the concept of Infinity is wrapped up in all this. It must take infinite power to fashion something out of Nothing. Quantum fields are something. Strings, or whatever else might be wiggling about and forming particles, are something. Energy is something. Nothing is the complete absence of every physical thing. If creation isn’t a movement, what is it? That’s what, in part, the next chapter answers.

Chapter 18 How to solve the objections about creation (alternate translation)

[1] FROM this we may see the vacuity of those who gainsay creation by arguments taken from the nature of movement and change: such as that creation must needs, like other movements and changes, take place in some subject, and that it implies the transmutation of non-being into being, like that of fire into air.

[2] For creation is not a change, but the very dependence of created being on the principle whereby it is produced. Hence it is a kind of relation. Wherefore nothing prevents its being in the creature as its subject. Nevertheless creation would seem to be a kind of change according only to our way of understanding: in so far, to wit, as our intellect grasps one and the same thing as previously non-existent, and as afterwards existing.

Notes Hold this: “creation is…the very dependence of created being on the principle whereby it is produced.” In our limited way, we say creation is a change because “our intellect grasps one and the same thing as previously non-existent, and as afterwards existing.” But it is not a change in something.

[3] It is clear however that if creation is a relation, it is a thing: and neither is it uncreated, nor is it created by another relation. For since a created effect depends really on its creator, this relation must needs be some thing. Now every thing is brought into being by God. Therefore it receives its being from God. And yet it is not created by a different creation from the first creature which is stated to be created thereby. Because accidents and forms, just as they are not per se, so neither are they created per se, since creation is the production of a being, but just as they are in another, so are they created when other things are created.

[4] Moreover. A relation is not referred through another relation,—for in that case one would go on to infinity,—but is referred by itself, because it is essentially a relation. Therefore there is no need for another creation whereby creation itself is created, so that one would go on to infinity.

Notes Creation is a relation (say that thrice), but the relation cannot be from some “deeper down” thing, that itself was created from some deeper down thing, and so on. It has to bottom out. There must be a base which is responsible for everything. Next week we learn more about what this base must be.

Angry Ovulating Women, Women Angry At Ovulation

According to the article, this is a " stock image of an angry female".
According to the article, this is a ” stock image of an angry female”.

Well, here’s the headline: “How women can tell when other females are ovulating using clues in their face – and how they may then try to hide their partners from the ‘threat’ of these fertile ladies” (discovered by reader Ken Steele).

I was intrigued because of a stock photo purporting to be an “angry female”, shown above. I thought, is this the best they can do for an “angry female”? Was Hillary Clinton not available that day? No feminists circulating about in the newsroom?

Anyway, the news report is based on the peer-reviewed paper “Can women detect cues to ovulation in other women’s faces?” by Janek S. Lobmaier, Cora Bobst, Fabian Probst in Biology Letters. I can’t do better than the abstract at summarizing what happened (with added paragraphification and emphasis):

Recent research suggests that men find portraits of ovulatory women more attractive than photographs of the same women taken during the luteal phase. Only few studies have investigated whether the same is true for women. The ovulatory phase matters to men because women around ovulation are most likely to conceive, and might matter to women because fertile women might pose a reproductive threat.

In an online study 160 women were shown face pairs, one of which was assimilated to the shape of a late follicular prototype and the other to a luteal prototype, and were asked to indicate which face they found more attractive…

In addition to choosing the more attractive face, these participants were asked which woman would be more likely to steal their own date.

Because gonadal hormones influence competitive behaviour, we also examined whether oestradiol, testosterone and progesterone levels predict women’s choices. The women found neither the late follicular nor the luteal version more attractive. However, naturally cycling women with higher oestradiol levels were more likely to choose the ovulatory woman as the one who would entice their date than women with lower oestradiol levels. These results imply a role of oestradiol when evaluating other women who are competing for reproduction.

The paper opens “Women have been reported to dance and walk, sound, smell and look more attractive during the fertile days of their menstrual cycle. Most of these studies looked exclusively at preferences of men as men directly benefit from ovulation detection in women…” Who knew? There are also clues, subtle and masked, that men find non-ovulating women angrier, especially during a certain phase of a woman’s menstrual cycle.

But never mind that. Here’s the picture, slightly modified, of the oestradiol level of the women in the pictures by the percent the participants thought the pictured women would steal their dates. I removed the regression line (via an inexpert use of Gimp) which the authors had.

The author's figure 2.
The author’s figure 2.

Now consider that if the participants were asked to pick which of a pair of photographs, and there was no real difference in those photographs, the rate would be somewhere around 50% regardless of the level of oestradiol. Is it?

Whatever skill women have in picking out competitors (in this sense) based on oestradiol levels of their enemies, it at least isn’t strong. The regression line, which I removed, wasn’t much to look at, either. But it did give a wee p-value, which is defined as a p-value less than the magic number, and which is taken as proof of cause.

The conclusion states

…men find the ovulatory face more attractive. Such results can be interpreted as men’s ability to detect ‘leaky cues’ to ovulation, serving men in the arms race between women’s effort to conceal ovulation and men’s selective advantage to detect it. Alternatively, men’s preference for ovulatory cues might occur because facial signals of ovulation are identical to what is typically seen as attractive in women’s faces.

Isn’t that interesting? It says, scientifically speaking, beauty is objective. That can’t be politically correct.

On Coincidence And Fortune: Why So Many One-Eyed Generals?

Kutuzov is at the left.
Kutuzov is at the left.

Plutarch opens his Life of Sertorius with these two sentences:

It is perhaps not a matter of surprise, if in the lapse of time, which is unlimited, while fortune is continually changing her course, spontaneity should often result in the same incidents; for, if the number of elemental things is not limited, fortune has in the abundance of material a bountiful supply of sameness of results; and, if things are implicated in a dependence upon definite numbers, it is of necessity that the same things must often happen, being effected by the same means.

Now, as some are pleased to collect, by inquiry and hearsay, from among the things which accidentally happen, such as bear some likeness to the works of calculation and forethought: such, for instance, as that there were two celebrated Atteis, the one a Syrian and the other an Arcadian, and that both were killed by a wild boar; that there were two Actaeons, one of whom was torn in pieces by his dogs and the other by his lovers; that there were two Scipios, by one of whom the Carthaginians were first conquered, and by the other were cut up root and branch; that Troy was taken by Hercules, on account of the horses of Laomedon, and by Agamemnon by means of the wooden horse, as it is called, and was taken a third time by Charidemus, by reason of the Ilians not being able to close the gates quick enough, owing to a horse having got between them; that there are two cities which have the same name with the most fragrant of plants, Ios and Smyrna, and that Homer was born in one of them and died in the other: I may be allowed to add to these instances, that the most warlike of commanders and those who have accomplished most by a union of daring and cunning, have been one-eyed men, Philippus, Antigonus, Annibal, and the subject of this Life—Sertorius; he whom one may affirm to have been more continent as to women than Philip, more true to his friends than Antigonus, more merciful to his enemies than Annibal, inferior in understanding to none of them, but in fortune inferior to all; and, though he always found Fortune more hard to deal with than his open enemies, yet he proved himself her equal by opposing the experience of Metellus, the daring of Pompeius, the fortune of Sulla, and the power of the whole Roman state; a fugitive and a stranger putting himself at the head of barbarians.

To this list of cylopsian colonels can be added Nelson, who gave us that most useful of phrases “turning a blind eye”, World War II’s Archibald Wavell, who dared outshine Churchill and who paid the price, Moscow’s tenacious defender and ruiner of Napoleon Marshal Kutuzov, defender of the heretical Jon Hus (the forerunner of the protesting Martin Luther) the Czech Jan Zizka, who in death and by his own order was turned into a drum so that his followers would ever follow his beat, Admiral Don Blas de Lezo, Spain’s greatest naval hero (it would have been Alonso Pérez de Guzmán if not for a spot of unfortunate weather), who beat back the Brits at Columbia. Even Odin, the chief Norse God, had unocular vision: the loss of his eye was voluntary; he exchanged exterior for interior vision. Come to think of it, it’s not clear whether the all-seeing Horus should be added to this list. Ask your dollar. Doubtless there are others (my knowledge of Asian commanders is limited).

The question is are these coincidences or are these meaningful? Plutarch says the former. He dismisses gently those who “are pleased to collect, by inquiry and hearsay, from among the things which accidentally happen” as if some guiding force caused the collection, for this is what must occur if there is meaning in any collection: some agency—God, say, angels or demons, a.k.a. the gods—must act to bring about the events. One-eyed generals, says God, must exist to teach men lessons; thus, sayeth the Lord, I shall cause the eyes of certain warriors to be put out, so that in their blindness all shall see.

There are other explanations. Some 1,600 years before Bernoulli, Plutarch intuits the law of large numbers, saying that “spontaneity should often result in the same incidents” given the opportunities to occur are large. This is not to say probability is causative, but that so many great commanders should be half blind is therefore not surprising given man’s warlike nature. Generals start as Lieutenants, the best are tested in battle, and battles are places where pieces of men’s anatomy go missing. Those men not able to overcome their loss are scarcely heard from again; the most tenacious treat their wounds with disdain; they not so much persevere but conquer themselves—and then their enemies.

Of course, both explanations could be true; there simply is no way to tell from the “data”.