Op-ed: Medics facing severe ethical dilemmas

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Last Updated on: 6th June 2020, 02:50 pm

By James William Mugeni

USA—6, June 2020: Do we still hold the value of the Hippocratic Oath? This might not apply so much to us, the medical clinical officers, the nurses and other allied professionals. However, there are increasingly difficult circumstances in which our colleagues, the doctors are finding themselves into in the face of politicians. What happens when doctors take political appointment? I will recite the Hippocratic Oath here for the sake of the basic principles of medicine that we must uphold.

“Hippocratic Oath- Modern Version.”

I swear to fulfill, to the best of my ability and judgment, this covenant:

I 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.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will 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.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, 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.

I want to share my thoughts with all of you regarding the events that took place in Minneapolis, USA last week and the continuing turmoil. Like you, I have been deeply saddened and troubled by what I have heard and seen. Most of us want to be morally neutral or just do not know how to act. 2, 000,000 Jews lost their lives in the Second World War in concentration camps under the watchful eyes of health professionals “Moral Neutrality.”

As a writer whose reason for existence is health and a medical clinical officer, I am dedicated to human life, liberty, and justice. I believe in the inherent dignity of all people. This transcends race, religion, sexual orientation, gender identity, national origin, or economic status. Something I have got missing since I stepped in America. To the extent that I am only a medical clinical officer as long as I have not left Uganda (Africa).

As a professional, I cannot watch the killing of George Floyd and the violence that has erupted during otherwise peaceful protests in response without deep sadness. However, I am seeing and facing the impacts of systemic racism in healthcare for decades in America, these recent events sharpen my resolve to demand justice, truth, and dignity for all. This, you have seen it in my write-ups and I cannot be more resolute than now writing for Health-in-Africa-world.

At the beginning of Covid-19, when all of us were questioning why the cases of Covid-19 are far too many in America, I did explain and posted that America health system lacks social justice. It is a system built for the rich.

It has no connection with the poor. I started calling attention to working to address the dramatically disparate impacts that the Covid-19 pandemic has had on the blacks. A hugely disproportionate share of Covid-19 cases in the United States are among African Americans and other minorities. Many of us immigrants and black people work in healthcare, transportation, emergency or other essential services, yet our society fails to treat us with the dignity that every American not only deserves but is entitled to under the U.S. Constitution.

Racial disparities in health status are not new to us. Solving for these problems is at the heart of what we do as health professionals. We provide health care to all who are in need. That is our basic principle.

But racial inequity is far more than a health issue, as recent events demonstrate all too well. Health problems begin with and are exacerbated by so many other factors, from housing to hunger, education to employment.

Access to health care is a critical factor that we and other health care systems work so hard on, but we need entire nations committed to addressing all the reasons health equity is so elusive—just as we must commit to equal justice for all.

We must remain resolute and focused as health professionals, and we are here to work with all organizations who share our beliefs and will join us on the journey towards a better world for all people.

We must believe that after this time of darkness, there will be a dawn. We both pray that the convergence of this virus that seeks the most vulnerable, and the deplorable deaths of George Floyd, and so many others that have led to the heartfelt protests we are seeing across the world will finally be a wake-up call.

Eyes can no longer be closed. Heads cannot be turned. Attention not diverted. Blame not shifted, let us call for justice system across the board. Silence is no longer acceptable. We cannot be morally neutral health workers, we are at the front of all these but without raising voices. Why treat if we cannot talk for those we treat?

As voices are lifted in protest, our hearts remain steadfastly committed to non-violence. We must turn away from any who seek to create more harm and honor the memories of all of those we have lost by acting in peace. Together, we can walk the talk for the voiceless as professionals.

Political appointments, political actors are forcing most of us professionals to seem to forget our own oath. My country Uganda has actors come up with trumped-up charges against patients in ambulances and hospitals. We have seen stretchers cases brought to Courts of Law. A patient under medical care is not a criminal that is the safest place before last office. Healing never occurs in the hands of adversaries, we are a healing ministry.

I have seen contradicting autopsies, especially in Uganda, the state overrules reports from pathologists and uses their own. Does it mean we use our oath relatively? And those of you who are charged with autopsies who do you “revere” when it comes to medicine?