Ethical Philosophies and the Hippocratic Physician

Ethical Philosophies and the Hippocratic Physician

Twenty four centuries ago, Hippocrates created the profession of medicine, for the first time in human history separating and refining the art of healing from primitive superstitions and religious rituals. His famous Oath forged medicine into what the Greeks called a technik, a craft requiring the entire person of the craftsman, an art that, according to Socrates in his dialogue Gorgias, involved virtue in the soul and spirit as well as the hands and brain. Yet Hippocrates made medicine more than a craft; he infused it with an intrinsic moral quality, creating a “union of medical skill and the integrity of the person [physician]” (Cameron, 2001).

So, how do we who are aspire to be Hippocratic physicians achieve this goal? First we must look at the foundations for our personal ethical frameworks through meta-ethics. Meta-ethics refers to the systems by which we establish morals and ethical principles. Today there are many philosophies of meta-ethics, divided into two basic categories, moral absolutivism and moral relativism (Lawhead, 2000). The difference between these is in the nature of ethical principles, whether subjective or objective. Say something exists objectively, like a vase on a table. The subject’s perception of the vase must conform to the true vase. If, however, the subject is simply thinking about a vase, that vase exists subjectively, and its properties are contingent to the subject’s contemplations. So, how do these differing systems affect the physician in attaining the Hippocratic ideal? Let us first consider relativism.

To the Moral Relativist, moral principles are created within cultures and communities, coming from cultural folkways and mores (Gerson Moreno-Riaño, personal communication). These principles are normative only in the culture which created them. Already, the Hippocratic Oath loses its moral weight. For example, in the 1973 Roe v. Wade abortion, Justice Blackmun dismissed the centuries-long Hippocratic tradition as merely a “Pythagorean manifesto,” relegating it to minority status (Cameron, 2001). However, relativism does not end here.

If moral principles are defined by cultures, how does one define a culture? If a social scientist were to dissect cultures into subcultures, and then divide those as well, he could logically continue making “cultural distinctions” until he comes to individuals as separate cultures. As a culture of one, each individual by relativism’s definition creates his own moral principles. This could be called ethical egoism (David Mills, personal communication). As logical conclusion extension of relativism, ethical egoism creates a world of moral lone rangers, with no one responsible to answer to any other.