What is violated when a person shouts “fire!” in a movie house, or cracks a “bomb” joke in an airport? The rational basis of such liability is the scare and commotion that such acts may unnecessarily bring the general public.
How similar (or different) is it when a doctor, a man of science, publicly talks against the vaccine, which is a product of science? Can a doctor invoke the right to freedom of expression as justification for such an act, which may lead to scare and commotion? If the doctor is indeed certain of the disbelief for the vaccine and becomes an anti-vaxxer, is the professional judgment to warn the public ethical and legal? Is it any different when an ordinary person, who neither took the Hippocratic Oath nor is governed by a Code of Ethics, decides to do such an act of standing against the scientific consensus of modern science? Could a doctor be liable legally, ethically, or morally, when he or she comes out in the open to stand against what humanity is convinced to believe as the great savior in the pandemic?
We live in a polarized society. The tug-of-war is not only between economics and health but also between those who are in favor and those who are against the imposition of quarantine, wearing of masks, and, of course, vaccines. And it is not surprising that even the medical professionals are not in solid agreement with what is for the good of the people.
Is agreement necessary anyway? In a situation when even science is not certain of many things, especially in the areas that only time will tell, like the long term effect of vaccines, would doubts be taken against those who express it? What if the context of their doubts proves to be right in the future, but for now no one can tell? And in an agile response where we are all witnesses to the changing (and sometimes contradictory) understanding, policies, and responses, who can we really trust?
Oath of Hippocrates
Written in antiquity, The Hippocratic Oath principles are held sacred by doctors to this day—treat the sick to the best of one’s ability, preserve patient privacy, teach the lessons of medicine to the next generation, and so on. It first appeared in 400 BC and was rediscovered by German Medieval Scholars in 1500. It was translated and interpreted by Ludwig Edelstein in 1943 and was rewritten by Louis Lasagna, the Academic Dean of the School of Medicine at Turfs University in 1964. In the Philippines, the Hippocratic Oath is part of the Oathtaking ceremonies of new physicians and recited, as a reminder, occasionally during physicians’ gatherings.
But the ancient relic, remaining as an expression of ideal conduct for physician, is not free from criticism like in its failure to echo the shared core of moral values considering the oath’s pagan origins. It makes no connection with many contemporary issues since medicine has developed into a more complex and diverse science. To some doctors, oath-taking is a little more than a ritual with little value beyond that of upholding tradition. Some physicians claim what they call the “Hypocritic Oath” should be radically modified or abandoned altogether.
The Oath’s foremost message focuses on patients’ best interests. The central theme remains that the purpose of medical care is to benefit the ill and that the patient’s needs should be considered above all else, making the classical Hippocratic Oath the foundation of modern medicine, promoting the practice of integrative care and codifying ethical behavior for medical professionals. As a code of professional identity, the Oath has had a powerful impact on modern judicial opinions regarding medical ethics. The Oath has exemplified the fundamental modern ethical principles of beneficence, non-maleficence, and confidentiality. It has also underlined the importance of respect between practitioners and patients. In a lot of ways, it is as relevant of the values of contemporary medicine as it was for ancient medicine.
Hippocratic Oath and the Anti-vaxxers
But how is the Hippocratic Oath violated when doctors publicly talk against the vaccines? Or, is there a violation at all? I shall leave it to the judgment of the readers as I present here, verbatim, the lines of the Hippocratic Oath.
The Hippocratic Oath contains a commitment that the doctors will “respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.” Isn’t the vaccine a hard-won scientific gain of science?
The Oath also commits the doctor to “apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.” Will the doctor, being a non-believer of vaccines, not prescribe or recommend it even if evidence of science has indicated its benefits for the patient?
The Oath also prescribes that doctor need “not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.” Are doctors, whose specialty is not infectious disease and who are not experts in the science of vaccine, duty-bound to refer their patients to colleagues who know the vaccine better? Are the doctors who are not experts in these special areas of medicine not violating this responsibility to refer what they do not know to those who know better?
In the Oath, doctors also commit to “prevent disease whenever I can, for prevention is preferable to cure.” Isn’t it that, for the longest time, vaccines have been a major strategy for prevention of disease?
This article is not judging those who do not believe in the vaccine. Neither is it encroaching into the doctor’s freedom to express his or her views—which if one is not an expert is mere opinion, and opinion is not a valid evidence in the world of science. But with freedom comes the responsibility, and the professional title is not a right but a privilege. That makes the doctor’s statements and positions, even views, different from that of a layman. In the midst of fake news and rampant misinformation in traditional and social media, the information-consuming public need responsible messengers and valid content, especially from doctors they trust.
But here is the most powerful question, how can you be a medical professional without believing in the science of the vaccine?
If there is one sector that society is seeing as a solid group, it is the medical professionals. Why? Because they hold in their hands the hope to end this pandemic, together. Anything less than that is disappointing and discouraging. The Hippocratic Oath has that unity in context what it made doctors swear to “not violate this oath.” It also assures doctors “may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.” The greatest challenge of our history is this pandemic. May all doctors unite so we can heal as one.
(Next issue: The Medical Code of Ethics and the Anti-vaxxers)