We live in an age of technological medicine, benefiting greatly from its probings and treatments. Yet patients’ encounters with it can leave much to be desired (see “Prescription: Networking”). In addressing those deficiencies, there is no better place to begin than a text produced 2,500 years before the modern technological era.
The work is an essay called “The Art,” produced by Hippocrates and his disciples in ancient Greece. In his time, practitioners of medicine considered their discipline to be an art, not a science. This meant, in essence, that doctors knew they must use their ethical judgment to direct the limited number of interventions in their therapeutic arsenal.
The Hippocratic physicians were concerned that intemperate use of these therapies could have damaging consequences. Applying them inappropriately, to illnesses where they were unlikely to help, undermined patients’ confidence in the treatments, the doctor, and medicine itself. It also transgressed an important principle of the Hippocratic Oath: do no harm. This precept is often misunderstood to mean that doctors must not inflict harm in the process of care. This is frequently impossible: we accept pain and side effects as the price of beneficial treatments. What “do no harm” means, as I interpret it, is that doctors must avoid exposing patients to preventable risks.
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