3 ms·

"Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course" Isn't this just chemotherapy? It seems like we already br

"Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course" Isn't this just chemotherapy? It seems like we already break the Hippocratic Oath quite regularly and many people are glad we do!

A_D_E_P_T 2y ago
"Chemotherapy = Poison" is a meme. In truth, "the dose makes the poison," as has been known since even before Paracelsus' time. In chemotherapy, strong and destructive drugs are indeed administered, but the aim is never to kill the patient, but instead to buy that patient -- otherwise facing an incurable and invariably fatal disease -- more time. In some cases, to cure that patient or send them into a long-lasting remission. This is not "poisoning" the patient. It is just the opposite; it is therapy with an eye towards lengthening the life of that patient.
- metalcrow 2y ago
  In that case then, what is a poison? What is the intent of the oath, if it's literal meaning is different from the intent? What does it mean to not poison people? It can't strictly be "you must never do anything that shortens people's lives" because then hospice care would be unethical.
  - A_D_E_P_T 2y ago
    Did you miss the point I made in my previous post? Strychnine can be a poison or it can be a tonic. If you take 1mg, it'll improve your athletic performance. If you take 100mg, you'll probably die. Acetaminophen is totally harmless in very small doses -- it's given to infants every day. Take too much, however, and it'll kill you. In adults, it's responsible for nearly half of all cases of acute liver failure in the US, and hundreds of deaths annually. Is it a poison? I could go on all day. Almost every drug can be a "poison," and, at the same time, only very strong toxins with zero therapeutic window are inherently poisons. In the context of medicine, whether or not something is a poison hinges on the drug, the dose of that drug, its expected therapeutic effect (which is basically statistical), and the condition of the patient. In cancer, where the condition of the patient is very unfortunate indeed, sometimes only very strong drugs with powerful side effects can provide any hope of eventual relief. Surely you see... > What is the intent of the oath, if it's literal meaning is different from the intent? ...That the intent is to hopefully provide that relief. > What does it mean to not poison people? ...That offering something that might cure or abate the patient's underlying condition is the very opposite of poisoning them.
    - metalcrow 2y ago
      I understand that, but you see how that "intending to provide relief" is very very different from the original statement of "Neither will I administer a poison to anybody when asked to do so", right? Sure, words and context and meaning can change, but this is a very significant change in meaning such that quoting the original statement without clarification is misleading. Plus, how does that answer my other question? You say the Hippocratic oath's true meaning is that a doctor must provide relief, right? What is a greater relief then death? Or less flippantly, who gets to decide what relief is, if not the patient? And if they do, can't they decide death is a relief? I'm just unclear on how your quote from the oath makes it clear that euthanasia violates it.
      - A_D_E_P_T 2y ago
        "Neither will I administer a poison to anybody when asked to do so" = "neither will I administer a substance I know to be deleterious or harmful to life." The very first definition of "poison" in the OED is: "Material that causes illness or death when introduced into or absorbed by a living organism." Medicine has a therapeutic window that's context-dependent. Part of the doctor's job, which is why they make real money and have relatively high social status, is determining the right course of treatment from that context. To cure -- not to harm, not to kill. If a cure is impossible, to comfort. > What is a greater relief then death? Or less flippantly, who gets to decide what relief is, if not the patient? Patients have every right to refuse treatment. They can also end their own lives; nothing could be simpler. What's perverse is forcing the medical establishment -- in view of its other responsibilities, duties, and oaths -- to act as executioner. It disgraces everybody involved. The doctor ends up dishonored, the state itself is shamed, the human dignity of the patient is, frankly, severely reduced.

A_D_E_P_T 2y ago

"Chemotherapy = Poison" is a meme. In truth, "the dose makes the poison," as has been known since even before Paracelsus' time. In chemotherapy, strong and destructive drugs are indeed administered, but the aim is never to kill the patient, but instead to buy that patient -- otherwise facing an incurable and invariably fatal disease -- more time. In some cases, to cure that patient or send them into a long-lasting remission. This is not "poisoning" the patient. It is just the opposite; it is therapy with an eye towards lengthening the life of that patient.

metalcrow 2y ago
In that case then, what is a poison? What is the intent of the oath, if it's literal meaning is different from the intent? What does it mean to not poison people? It can't strictly be "you must never do anything that shortens people's lives" because then hospice care would be unethical.
- A_D_E_P_T 2y ago
  Did you miss the point I made in my previous post? Strychnine can be a poison or it can be a tonic. If you take 1mg, it'll improve your athletic performance. If you take 100mg, you'll probably die. Acetaminophen is totally harmless in very small doses -- it's given to infants every day. Take too much, however, and it'll kill you. In adults, it's responsible for nearly half of all cases of acute liver failure in the US, and hundreds of deaths annually. Is it a poison? I could go on all day. Almost every drug can be a "poison," and, at the same time, only very strong toxins with zero therapeutic window are inherently poisons. In the context of medicine, whether or not something is a poison hinges on the drug, the dose of that drug, its expected therapeutic effect (which is basically statistical), and the condition of the patient. In cancer, where the condition of the patient is very unfortunate indeed, sometimes only very strong drugs with powerful side effects can provide any hope of eventual relief. Surely you see... > What is the intent of the oath, if it's literal meaning is different from the intent? ...That the intent is to hopefully provide that relief. > What does it mean to not poison people? ...That offering something that might cure or abate the patient's underlying condition is the very opposite of poisoning them.
  - metalcrow 2y ago
    I understand that, but you see how that "intending to provide relief" is very very different from the original statement of "Neither will I administer a poison to anybody when asked to do so", right? Sure, words and context and meaning can change, but this is a very significant change in meaning such that quoting the original statement without clarification is misleading. Plus, how does that answer my other question? You say the Hippocratic oath's true meaning is that a doctor must provide relief, right? What is a greater relief then death? Or less flippantly, who gets to decide what relief is, if not the patient? And if they do, can't they decide death is a relief? I'm just unclear on how your quote from the oath makes it clear that euthanasia violates it.
    - A_D_E_P_T 2y ago
      "Neither will I administer a poison to anybody when asked to do so" = "neither will I administer a substance I know to be deleterious or harmful to life." The very first definition of "poison" in the OED is: "Material that causes illness or death when introduced into or absorbed by a living organism." Medicine has a therapeutic window that's context-dependent. Part of the doctor's job, which is why they make real money and have relatively high social status, is determining the right course of treatment from that context. To cure -- not to harm, not to kill. If a cure is impossible, to comfort. > What is a greater relief then death? Or less flippantly, who gets to decide what relief is, if not the patient? Patients have every right to refuse treatment. They can also end their own lives; nothing could be simpler. What's perverse is forcing the medical establishment -- in view of its other responsibilities, duties, and oaths -- to act as executioner. It disgraces everybody involved. The doctor ends up dishonored, the state itself is shamed, the human dignity of the patient is, frankly, severely reduced.