“First, do no harm.” This is not technically part of the Hippocratic Oath, but it’s consistent with its values. So naturally, it’s got to go:
Remember that once you change the idea that docs never kill to the idea that killing is mandatory if “asked,” then you get docs (and nurses) who decide to be god and doing the killing spontaneously, or causing a person to die indirectly, not because the treatment won’t really help the patient, but merely because the patient is looked down on as useless, so why not?
An unfortunate incident to illustrate:
Once I worked a few weeks filling in at the ER at one of the IHS hospitals in the Sioux area. While I was giving report to my replacement, a moonlighting resident who worked in Baltimore but flew in to help on the weekend, one of the staff members came in to ask if we would check an x ray that the feeding tube was placed correctly so they could tube feed a lady with a recent stroke until her swallowing ability improved.
The resident, however, said: “Why don’t you just give her morphine, haha”… (implying we shouldn’t feed her but just sedate her into a coma and let her die of dehydration etc). The staff doctor said “WHAT?” and the resident repeated the same thing.
The staff doctor said quietly: “well, we don’t do things that way here,” and left, telling the nurse he would be back later in the evening to check the x ray.
I kept silent, since I had no authority here but knew my next door neighbor was a member of the American Indian movement and would have her group intervene if this was done.
But you know, I wonder how many poor black patients he cared for in Baltimore also got “morphine, haha.”
The black community already distrusts the medical community but since elder suicide is seen as a problem for rich white people, they aren’t worried about this. Yet.
“First, do nothing”?