Lucanus Gynaecology

The Ethical Foundations of Practice

 

Uncertainty of the present moral environment

 

The practice of medicine especially in the Western World is becoming increasingly associated with an economy of service and reward. Realistically, it cannot be otherwise in circumstances where the operation of a medical facility occurs in an economy where costs of operation have to be derived from the payment for services. Without such fees and payments, the practice would become non-viable.

This economic fact introduces a tension into medical practice, where many practitioners prefer to avoid charging sick patients or their relatives for services. In many countries, doctors have had the opportunity to practice medicine as salaried employees of governments who pay the operational costs from general taxation, thus making the provision of medical care free to the patient at the point of service. This practice is vulnerable to loss of patient autonomy which varies according to the multilateral relationship environment, and the practice is also vulnerable to resource constraints, against which the doctor and the patient are helpless.

In the current era, problems have arisen with delivery of medical services within such organisations. In some public hospitals delivery of services may be constrained by funding limits set by the government. In other health-insured services, managed care has had similar results. Waiting lists for both specialist consultation and surgery are common, and for some afflictions act to effectively deny or significantly delay service to the patient.

In addition, given the liberalisation of personal belief, and the pervasive assimilation of political correctness, there has arisen an intellectual climate where moral right and wrong do not exist, only a relativism in which each person has the right to hold beliefs of his/her choice.

The uncertainty engendered by this moral relativism affects the doctor/patient relationship when the patient suffers an internal enquiry as to what is the motivation of the doctor treating him/her. If a doctor is advising a pregnant patient regarding possible fetal anomaly, she naturally wishes to know the doctor's regard for unborn children and attitude to abortion. If a doctor is caring for a patient with a terminal condition the patient and his/her relatives naturally wish to know the doctor's attitude to sanctity of life and euthanasia.

 

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Codes of belief and conduct traditionally associated with Western Medicine

 

Lucanus Gynaecology holds conformity to the moral precepts contained in the Oath of Hippocrates and the Decalogue from the Old Testament of the Christian Bible as a mission objective in its provision of specialist gynaecological medicine.

 

Since the fifth century before Christ, medicine has developed under a code of conduct articulated by Hippocrates, and presented as the Oath of Hippocrates. The Oath is a comprehensive statement of the motivation of practice of a physician, and the obligations of the doctor to colleagues and patients. In the 20th century, following the Second World War, more "modern" versions of the Oath have been produced, but they have not maintained all of the essential features of Hippocrates' original.

 

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The Oath as elaborated by Hippocrates reads as follows:

 

The Oath of Hippocrates