“With all the rights, privileges and responsibilities” . . . Hippocrates and the Practice of Medicine – Part 3

For many of us, using unproven techniques, unless as part of an approved research protocol, is not even a consideration. However, many good and caring physicians continue to be drawn in by the hype surrounding these techniques. These new techniques may, in fact, prove to be valuable and worthy of widespread implementation. However, we must insist—no, we must demand— that these nonstandard approaches are performed only under clinical research protocols until data on efficacy, safety, and cost-effectiveness can be provided to our patients. As a modern version of the Hippocratic Oath instructs, “I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

Often in the practice of Medicine, the lack of specific regulation require us to accept the responsibility to self-regulate. We must always respect the patient’s rights to be completely informed of the treatment they are to undergo. Specifically, they must be apprised of the reason for the treatment, the expected results, the duration of treatment, potential side effects, and the total cost of treatment. Our patients, our colleagues, and the regulatory authorities hold us, as physicians to a higher level. We need to define what is and what is not standard treatment . . . or it will be defined for us. Nonstandard treatment may, in fact, be better then standard treatment, but we need to validate efficacy in approved protocols that protect the patient and the patient’s rights. From this, we cannot waiver. It is our responsibility. It is our Oath.

As I listened to the recitation of the Hippocratic Oath and reveled in the euphoria I shared with these new graduates, I realized that by upholding its doctrine to “ . . . 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” that we will continue to answer a higher calling, serve and protect the needs of others, and maintain the responsibility we have as healers.

Bruce R. Gilbert MD PhD