Being Human: Readings from the President's Council on Bioethics
Chapter 3: To Heal Sometimes, To Comfort
We have considered the enduring human dream of perfecting
nature. We have seen how some great scientists perceive the
potential of the methodical pursuit of useful knowledge to
make this dream a reality, even as others seek to shield scientific
inquiry from utilitarian purposes. In our third chapter we
turn to medicine, where we see, among other things, the dream
of using knowledge to achieve perfect wholeness applied to
the vulnerable, mortal human body.
This is a dream that comes naturally both to doctors, who
see firsthand the suffering brought by disease and death,
and to the sick and dying, who seek deliverers. But can doctors
serve this desire for deliverance from the “natural shocks
that flesh is heir to”? Is that all they do? Is it what they
should do? Readings in this chapter explore the purposes of
medicine, from the point of view of both doctor and patient.
Taken together, they explore a vocation summoned to the work
of healing and comforting.
Our readings begin with the Hippocratic oath, which for
centuries encapsulated the ideals of medical purpose and physicianly
conduct. Fittingly, the oath begins and ends with an attempt
to locate the practice of medicine and the doctor himself
within the greater order.
But human beings have always wondered about the source of
healing and the relation between the doctor and the divine,
and Hippocrates’ word on these questions was not to be the
last. Our next two readings—one from the Book of Sirach, which
appears in the Catholic Bible, and one from Albert Camus’s
The Plague—further explore these mysteries.
Our fourth reading, “The Surgeon as Priest,” by surgeon
and writer Richard Selzer, offers a doctor’s view of what
it means to practice medicine. W. H. Auden follows with the
point of view of a patient, in this case a patient eulogizing
a beloved practitioner in “The Art of Healing.”
A doctor, however, does not always heal. A physician confronts
perhaps his hardest task when he knows he cannot be the deliverer
for whom his patient hopes. What are his obligations when
the news is bad? In the next three readings—“To One Shortly
to Die,” by Walt Whitman, and excerpts from Thomas Mann’s
Buddenbrooks and George Eliot’s Middlemarch—we
find doctors (or others) confronting the continuing illnesses
or certain deaths of those in their care. What should be done
for the patients themselves? What should be said to their
Finally, doctors stand in a privileged relation to their
patients, and the privilege is fraught with danger for both.
In our final reading, “Invasions,” doctor and writer Perri
Klass ruminates on one such privilege: the necessary invasion
of the patient’s privacy.
The Hippocratic Oath
translated by Leon R. Kass, M.D.
This oath, the oldest and best-known
expression of a medical ethic, was for centuries regarded
as the guide for proper medical conduct. Although the accomplishments
of modern medicine appear to have taken the discipline far
from its ancient roots, the oath continues to offer a powerful
account of what it means to be a doctor.
The oath begins by invoking ancient
Greek deities. The specific deities invoked are Apollo,
(here, “Apollo Physician”), the god associated with light,
truth, and prophecy; Asclepius, child of Apollo, the “father”
of medicine; Hygieia (whose name means “health,” “living
well”) and Panaceia (“all heal”), both daughters of Asclepius
and associated with what modern readers might call “prevention”
and “treatment.” The oath concludes with a plea, acknowledging
that the physician’s fortunes depend on his fulfillment
of its terms.
The six substantive paragraphs in between
address first (in the oath’s longest paragraph) how the
physician should comport himself with respect to his teachers,
as well as his teacher’s offspring, his own, and all other
students of medicine. Physicians are here, literally, called
into fraternity with one another; the gift of the medical
art is equated with the gift of life. The five subsequent
paragraphs indicate how the physician should conduct himself
with respect to his patients and their households. The first
three deal with the ends and means of treatment, appropriate
and inappropriate, the last two with decorum.
Why begin the oath with an invocation
of the gods? Why these gods? What does this beginning suggest
about the powers of the physician and their source?
Parents, rightly, often resent the
authority teachers have over their children. Yet, here,
physician-teachers are explicitly equated with fathers,
medical students with their sons. Is this equation or analogy
justifiable? Why or why not?
What attitude toward the medical arts
is expressed in the oath’s five paragraphs on ends, means,
and conduct toward patients and families?
What, according to the oath, is the
true purpose of medicine?
Can you explain and justify the limits
the oath places upon the uses of medical technique?
Except to say that a doctor must neither
kill nor suggest killing, the oath is silent on the subject
of death. What can one infer from the oath about a doctor’s
obligations to the hopelessly ill?
I swear by Apollo Physician and Asclepius and Hygieia and
Panaceia and all the gods and goddesses, making them my witnesses,
that I will fulfil according to my ability and judgment this
oath and this covenant:
To hold the one who has taught me this art as equal to my
parents and to live my life in partnership with him, and if
he is in need of money to give him a share of mine, and to
regard his offspring as equal to my brothers in male lineage
and to teach them this art—if they desire to learn it—without
fee and covenant; to give a share of precepts and oral instruction
and all the other learning to my sons and to the sons of him
who has instructed me and to pupils who have signed the covenant
and have taken an oath according to the medical law, but to
no one else.
I will apply dietetic measures for the benefit of the sick
according to my ability and judgment; I will keep them from
harm and injustice.
I will neither give a deadly drug to anybody if asked for
it, nor will I make a suggestion to this effect. Similarly
I will not give to a woman an abortive remedy. In purity and
holiness I will guard my life and my art.
I will not use the knife, not even on sufferers from stone,
but will withdraw in favor of such men as are engaged in this
Into whatever houses I may enter, I will come for the benefit
of the sick, remaining clear of all voluntary injustice and
of other mischief and of sexual deeds upon bodies of females
and males, be they free or slave.
Things I may see or hear in the course of the treatment
or even outside of treatment regarding the life of human beings,
things which one should never divulge outside, I will keep
to myself holding such things unutterable [or “shameful to
If I fulfil this oath and do not violate
it, may it be granted to me to enjoy life and art, being honored
with fame among all men for all time to come; if I transgress
it and swear falsely, may the opposite of all this be my lot.~