DOCTOR-PATIENT RELATIONHIP: STUDY AND ANALYSIS
...en to proclaim standards of conduct and ethical behavior identified and adhered to by physicians dating back as far as the Hippocratic Oath, the Principles of Medical Ethics set forth the basic moral tenets for the medical profession. These universal precepts are then interpreted and applied to new situations and protocols as they arise over time. The AMA (American Medical Association) Principles of Medical Ethics are a potent, vigorous contract of caring between physicians and patients. Commitment to these Principles distinguishes AMA physicians from all the others, and instills confidence in patients. Principles of Medical Ethics I. A physician shall be dedicated to providing competent medical service with compassion and respect for human dignity. II. A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception. III. A physician shall respect the law and recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient. IV. A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law. V. A physician shall continue to study, apply, and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talent of other health professionals when indicated. VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose Shuker 7 serve, with whom to associate, and the environment in which to provide medical services. VII.A physician shall recognize a responsibility to participate in activities contributing to an improved community. Source: Code of Medical Ethics: Current Opinions with Annotations © 1996 American Medical Association Shuker 8 Chapter 2 The Hippocrates oath and its applications in the contemporary world of medicine. A-Who is Hippocrates? Hippocrates, (377-460 BC), he is an extraordinary medical writer of Greece. Little is known of his life beyond the fact that he was a physician on the island of Cos that he belonged to the most intellectual period of Grecian life, and that Hippocrates was singularly free from superstition. Over eighty treatises have been attributed to him. Hippocrates has been called the father of scientific medicine. He did not believe in miraculous diseases or cures. He taught that proper diet is a necessity of health, and that climate has a profound influence on both mind and body. He died in Thessaly at an advanced age. Hippocrates is mostly known for his oath which is still taken by new doctors till these days. B-The Hippocrates oath: " I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not Shuker 9 cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!" (400 BC THE OATH by Hippocrates Translated by Francis Adams) As shown above this oath stresses on the ethical aspect of the medical profession, the doctor swears that he will practice his career with most dignity and decency. This oath commits the doctor to treat patients with clear conscious and never give any medicines which harm any person and never perform abortion surgeries etc….. C-How much the Hippocrates oath is practiced today? Taking in consideration the circumstances of the medical industry in the world in general, we find a major trend to consider the profession of medicine as a commercial profession rather than a humane one practiced by a man to help a fellow man overcome a disease. Although the Hippocrates oath is still performed until the current time by all the newly graduated doctors without ay exception, most of those doctors do not commit to that oath. They consider their profession as a gateway to fame and financial security disregarding the humane aspect of their job. This problem is worldwide; however, the United States has the biggest anti-commercialization of the medical profession movement. Just like Ralph Nadir who was the first man to Shuker 10 defend consumer rights, Dr. Hunter "Patch" Adams was the first who defended the patient's rights as a human being and not as a medical case. The Patch Adams story will be discussed in the next chapter. Shuker 11 Chapter 3 A-Who is Patch Adams? Hunter Adams is an American doctor who changed the way doctors treated patients in the USA. During the late sixties Adams was a young lost American who was deeply put down by the way he lived his life. He had no idea about what to do with his life and nothing made sense to him. After a while, he checked himself in to a mental hospital because he could not endure the life outside. In the mental hospital Adams found his mission in life. He realized that if anyone wants to forget about their problems they should think about helping others solving their problems. Hence, he decided to study medicine and become a doctor so he could help the most in need which are patients because "The loudest cry of patients was for compassion and attention which was a call for time "(The Gesundheit institute www.patchadams.org). After getting out of the hospital "Patch", as called by one of the patients in the hospital, joined the medical school where he had a great ambition to become the best doctor the world had ever known. In college, and since being a radical student and revolutionary person who wanted to change everything around him especially the way doctors treated patients in the university hospital, Patch Adams faced a lot of rejection and mistreatment from his teachers, and he was threatened to be suspended more than once. But despite all that the famous Patch Adams graduated as a fully ambitious doctor in the early seventies. B-The Patch Adams Effect on the American medical field. If you look at the changes that occurred in the doctor-patient relationship in the past few years, you'll notice a great different. Doctors now are obliged to respect the patient as an equal person who has feelings and need that should Shuker 12 be taken into consideration. A whole new word emerged among doctors that hadn't been known before. It is the "Quality of life" now doctors give major consideration to the quality of the patient's life rather than just his medical condition. Although this issue is still controversial, people are starting to believe that medicine is not just about prolonging life, it's also about improving it and as Robin Williams said as the great Patch Adams: "when you treat a disease you might win or you might lose; but when you treat a person I can guarantee you, you'll win no matter what the outcome is" . Patch Adams was a pioneer in reorienting the medical profession into its original goal which means a purely humane profession, his resolve and bravery changed the way America felt about doctors. A doctor is now more as a friend not just a therapist. C-The Patch Adams Movie and the coming to fame. Before 1999 no one knew the full story of Patch Adams. He was known among doctors on a small level. However, after the movie came out and hit very high, everybody inside and outside USA knew Patch Adams and his contribution to the rights of patients to be treated as persons. The film was starring Robin Williams and Monica Potter and was directed by Tom Shadyak. All the revenues from the movies were devoted to the construction of the new building of the Gesundheit hospital. D-The Gesundheit hospital. Gesundheit is a German word which is used as a "bless you" after a sneeze. But Gesundheit is also the name of the hospital Patch Adams founded in 1972. while he was at college, Patch Adams was very upset about what was happening in the hospitals in the US back then, so he decided to start the spark of change. He borrowed a small piece of land and built a small house on it. He used this house to receive patients as a clinic, however it was far from being a conventional clinic. Gesundheit was a place where everybody Shuker 13 (doctors and patients) were equal, no one is better than anyone. If you needed to clean a wound, if you had a fever, if you needed to talk, help, laugh or do anything that made you feel better, you could go to Gesundheit a nice warm place where you can find laughs, friendship, warmth just as much as medical treatment. The clinic services were free of charge on the condition that you participate in wit everyone. This was a very good idea and many people liked it, but it almost had Adams suspended from school on the basis that he practiced medicine without a license. After Patch graduated, he ran his clinic with the same concept and doctors from around the world volunteered to be part of the Gesundheit team. However, it stayed a small clinic in West Virginia until the movie came out based on the book written by Patch and obviously called Gesundheit. After the movie the clinic grew into a 6000 square foot area and the dream hospital is currently under construction. The Gesundheit mission and vision: To bring fun, friendship, and the joy of service back into health care. The Gesundheit! Institute is dedicated to upho...