Thursday, July 9, 2009

The Physician's Pledge

The recent discussions about whether a doctor is morally compelled to put his life on the line in dealing with pandemics and such, if nothing else, did highlight the level of ambiguity that exists in doctor's minds with regards to their moral obligations under such circumstances.

One comment in Angry Doc's blog pointed out: "I don't remember ever making any oaths to say I would die for my work."

That made me sit up a bit....

The Singapore Medical Council implemented a Physician's Pledge for graduating doctors in 1995. This was kinda inspired by the Hippocratic Oath, but is actually very similar to the Physician's Oath (adopted by the General Assembly of the World Medical Association, 1948 and amended by the 22nd World Medical Assembly, 1968).

The SMC Physician's Pledge reads:

"I solemnly pledge to:

dedicate my life to the service of humanity;
give due respect and gratitude to my teachers;
practise my profession with conscience and dignity;
make the health of my patient my first consideration;
respect the secrets which are confided in me;
uphold the honour and noble traditions of the medical profession;
respect my colleagues as my professional brothers and sisters;
not allow the considerations of race, religion, nationality or social
standing to intervene between my duty and my patient;
maintain due respect for human life;
use my medical knowledge in accordance with the laws of humanity;
comply with the provisions of the Ethical Code; and
constantly strive to add to my knowledge and skill.
I make these promises solemnly, freely and upon my honour."

I suppose the interpretation of that pledge will revolve around what we understand to be meant by "dedicate my life to the service of humanity" and "make the health of my patient my first consideration". What do they mean to graduands, and do those statements actually compel doctors to put their life on the line?

I know this pledge may be just words mechanically uttered by some graduands, but it is a solemn pledge and meant to be taken seriously.

The SMC's Ethical Code and Ethical Guidelines makes a more explicit statement in Para

"A doctor shall be prepared to treat patients on an emergency or humanitarian basis unless circumstances prevent him from doing so."

But I suppose that still requires us to interpret what it means by being prevented from doing so.

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