The Hippocratic Oath

A 56 year old, divorced, female patient lives with her 20 year old daughter. She was a well and very active math teacher. She started to complain of generalized pain, weight loss, severe headaches, and multiple seizure episodes. She was diagnosed as having a stage IV metastasis brain tumor. She received two cycles of chemotherapy, but refused radiotherapy. She soon developed hypoxic damage to her brain cells which left her paralyzed and blind. She has been lying in her bed depressed with no contact with the outside world. She is religiously cared for in every way by her daughter. She is suffering from intolerable pain and asks her doctor to allow her to die in peace. In the presence of her daughter, she signed an agreement consent form giving

the doctor permission to aid her in dying. Her doctor gave her a high dose of morphine that terminated her life immediately. Why was Euthanasia considered? Did the patient have the right to request to die? Despite the patient’s agreement and consent, was participating in euthanizing the patient considered ethical and / or professional behavior? Was the Hippocratic Oath violated? The ethical dilemmas that doctors’ face with euthanasia and assisted suicide have plagued society for many years (Naga, 2013).
The Hippocratic Oath is an oath stating the obligations and proper conduct of doctors, formerly taken by those beginning medical practice.

It is one of the oldest binding documents in history. Its principles are held sacred by doctors to this day. They promise to treat the sick to the best of one's ability, preserve patient privacy, and teach the secrets of medicine to the next generation, and so on (Tyson, P, 2001). The problem with the original version of the Oath is that it conflicts with the relationship that doctors have with their patients. The original version of the Oath says “that doctors cannot use euthanasia as well as be involved in performing abortions.” It also stated “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect” (Hippocratic, 2010). Statements of this type have drastically changed in the new version of the Oath. Today, most graduating medical school students swear to some form of the oath, usually a modernized version. In the new version the oath shows the extended freedoms given to the patient as well as the responsibility granted to the doctor allowing them the ability to participate in forms of euthanasia. As a result of the Oath changes, doctors are not violating the oath by participating in euthanasia (Hippocratic,

2010).
Euthanasia is the painless killing of a patient suffering from an incurable and painful disease or in an irreversible coma. It is the act of issuing medication to aid in the death of a person. There are two main types of euthanasia. The first is voluntary. Voluntary Euthanasia is with the patients consent. Patients request to die for many reasons. Most of the primary reasons are intolerable pain due to irreversible illnesses, financial burdens, refusing medical treatment or refusing to eat. When a patient asks to die or for assistance to die, they are considered coherent and able to make life decision on their own. The second is Involuntary Euthanasia. This type of euthanasia is without the patients consent. Patients are often unable to make decisions themselves due to being comatose, in a vegetative state, children, mentally disturbed, or brain damaged. An example of a moral and ethical decision by a doctor is “A soldier has their stomach blown open by a shell burst. They are in great pain and screaming in agony. They beg the army doctor to save their life. The doctor knows that they will die in ten minutes whatever happens. As he has no painkilling drugs with him he decides to spare the soldier further pain and shoots them dead” (Ethics, 2014). These are just a few of the involuntary decision that doctors are faced with on a daily basis. There are two procedural methods associated with euthanasia. They are the Active and Passive forms. The Active form of euthanasia occurs when the medical professionals, or another person, deliberately do something that causes the patient to die. This method is often performed through over prescribed medication. The form of passive euthanasia occurs by intentionally withholding proper lifesaving medications like a ventilator or breathing tube (Rachels, 2002). Although it is often thought to be the same, Assisted Suicide differs from Euthanasia. Assisted suicide is the suicide of a patient suffering from an incurable disease, affected by the taking of lethal drugs provided by a doctor for this purpose. The doctor does not actually administer the medication to the patient. This is just another pebble in the sea of doctors dilemmas (Ethics, 2014).