Tuesday, January 31, 2017

The Hippocratic Oath for Hypocrites

The Hippocratic Oath is an oath historically taken by doctors swearing to practice medicine ethically.  The Greek physician, Hippocrates, from the 5th Century B.C., is the author.  Adopted about 26 centuries ago it withstood the test of time for nearly 2,500 years before changes in 1948 and 1964, the last 67 years, effectively destroyed the original intent.

From the website Greek Medicine.net we learn the following.


Father of Medicine

Medical historians generally look to Hippocrates as the founder of medicine as a rational science.  It was Hippocrates who finally freed medicine from the shackles of magic, superstition, and the supernatural.  Hippocrates collected data and conducted experiments to show that disease was a natural process and that the signs and symptoms of a disease resulted from the natural reactions of the body to the disease process.  He also believed that the chief role of the physician was to aid the natural resistance of the body to overcome the metabolic imbalance and restore health and harmony to the organism.

Hippocrates was born on the island of Cos, off the southwest coast of Asia Minor, or present-day Turkey, around 460 B.C.  His father was a physician-priest in the Asclepion at Cos, and his family could trace its lineage back to the legendary Asclepius.  Hippocrates lived a very long life and died at a ripe old age in the town of Larissa in Thessaly.

The Hippocratic Revolution

When Hippocrates began to practice medicine, the established school of medicine was the Cnidian School, but this school's approach to medicine had several serious flaws, which were already becoming apparent and starting to cause a general dissatisfaction with the art of medicine.

The Cnidian School considered the body to be merely a collection of isolated parts, and saw diseases manifesting in a particular organ or body part as affecting that part only, which alone was treated.  Their system of diagnosis was also faulty, relying exclusively on the subjective symptoms related by the patient, while totally ignoring the objective signs of the disease.
Hippocrates radically disagreed with the Cnidian School, countering that the human body functioned as one unified organism, or physis, and must be treated, in health and disease, as one coherent, integrated whole.  In diagnosis, not only the patient's subjective symptoms, but the objective signs of the disease must also be considered to arrive at an accurate assessment of what was going on.

As his unifying theory for the holistic understanding of the human organism, and how it functions in health and disease, Hippocrates used the concept of the Four Humors.  Building on the groundwork of humoral physiology and pathology laid by his predecessors, Hippocrates finally brought the theory of the Four Humors into its classical form.

Health is a harmonious balance of the Four Humors.  Disease results from their disharmony and imbalance.  The physician's job is to restore health by correcting the imbalance and restoring harmony to the humors.

To quote Hippocrates:
"The body of man has in itself blood, phlegm, yellow bile, and black bile; these make up the nature of the body, and through these he feels pain or enjoys health.  Now, he enjoys the most perfect health when these elements are duly proportioned to one another in respect to compounding, power and bulk, and when they are perfectly mingled.  Pain is felt when one of these elements is in defect or excess, or is isolated in the body without being compounded with all the others."

The Nature of Man

Hippocrates took his band of renegade physicians with him to the island of Cos.  There, they set about to revolutionize the art of medicine and put its theory and practice on a truer, sounder footing.

Hippocratic Medicine

Physiology and pathology in Hippocratic medicine was based on the Four Humors.  A united confluence and sympathy between all four humors working together was necessary for good health.  Pneuma - the Breath or Vital Force, and the Innate Heat, which were suffused into the blood from the lungs via the heart, gave the blood the power to sustain life.
Hippocrates saw pepsis, or an orderly, balanced, harmonious digestion and metabolism of the Four Humors as being essential to all good health.  In disorders of pepsis Hippocrates saw the origin of most disease.

Hippocrates' anatomical knowledge was rather scant, but this is compensated for by his profound insights into human physiology and the soundness of his reasoning.  But even so, his surgical techniques for dislocations of the hip and jaw were unsurpassed until the nineteenth century.
In therapeutics, Hippocrates saw the physician as the servant and facilitator of Nature.  All medical treatment was aimed at enabling the natural resistance of the organism to prevail and overcome the disease, to bring about recovery.

In the treatments he prescribed, Hippocrates was very sensible, pragmatic and flexible in his approach, favoring conservatism and moderation over radical or extreme measures.  Bloodletting, which was much abused at other times in medicine's history, was used only rarely by Hippocrates, and even then, only applied conservatively.

Hippocrates placed great emphasis on strengthening and building up the body's inherent resistance to disease.  For this, he prescribed diet, gymnastics, exercise, massage, hydrotherapy and sea bathing.

Hippocrates was a great believer in dietary measures in the treatment of disease.  He prescribed a very slender, light diet during the crisis stage of an acute illness, and a liquid diet during the treatment of fevers and wounds.  

Hippocratic medicine was constitutionally based, so its approach to diagnosis and treatment was quite flexible.  As a holistic healing system, Hippocratic medicine treated the patient, and not just the disease.
Hippocrates was the first physician to systematically classify diseases based on points of similarity and contrast between them.  He virtually originated the disciplines of etiology and pathology.  By systematically classifying diseases, Hippocrates placed their diagnosis and treatment on a sounder footing.

The Hippocratic Corpus

The Hippocratic Corpus is a collection of over 60 works.  Although all of them are attributed to Hippocrates, the Corpus is of a heterogenous character, and many, if not most, of its works may actually have been written by his students.
Still, we can be fairly certain that Hippocrates actually did author many books in the Corpus, including many original, groundbreaking works.

These include:
Airs, Waters and Places - the first major work on medical meteorology, climatology, geography and anthropology.
Aphorisms - a collection of wise, pithy sayings giving advice on practical matters of diet, prognosis and therapeutics.
Ancient Medicine - a defense of the empirical study of medicine against one biased by preliminary axioms and assumptions.  Also deals with the Four Humors.

The Legacy of Hippocrates

Hippocrates was the personification of the ideal physician - wise, caring, compassionate, and honest.  His Hippocratic Oath, which set high ethical standards for the practice of medicine, is his most remembered achievement.  His exemplary life has been a constant and enduring source of inspiration for doctors and healers down through the ages.

The Hippocratic Oath

Contrary to popular myth, the phrase "First do no harm" (Latin: Primum non nocere)) is not part of the Hippocratic oath. Strictly speaking, the phrase does not appear in the oath, though an equivalent phrase is in Epidemics, Book I, of the Hippocratic school: "Practise two things in your dealings with disease: either help or do not harm the patient".  The exact phrase may have originated with the 19th-century surgeon Thomas Inman.

There were several modifications to the oath, with a significant revision in 1948 by the World Medical Association (WMA) called the Declaration of Geneva.  During post World War II and immediately after its foundation, the WMA showed concern over the state of medical ethics in general and over the world. The WMA took up the responsibility for setting ethical guidelines for the world physicians. It noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality". In Germany during the Third Reich, medical students did not take the Hippocratic Oath, although they knew the ethic of "nil nocere" - do no harm.

In the 1960s, the Hippocratic Oath was changed to require "utmost respect for human life from its beginning", making it a more secular obligation, not to be taken in the presence of God or any gods, but before only other people. When Louis Lasanga, Academic Dean of the School of Medicine at Tufts University, rewrote the Oath in 1964, omitted the prayer, and that version has been widely accepted and is still in use today by many medical schools.

Following are the Classic (original) version of the Oath, and the modern version resulting from the Lasanga revisions in 1964.  Note in the original version content in red represents sections altered in the modern version.

The Hippocratic Oath (Classic Version)

I swear by Apollo the Physician and Asclepius and Hygieia and Panaceia and all the gods, and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, who has instructed me and to pupils who have signed the covenant and have taken the oath according to medical law, but to no one else.

I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art–if they desire to learn it–without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

The 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 over treatment 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.

The Modern Version, written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, is used in many medical schools today.

The Rights and Responsibilities of the News Media


The press, or news media, are protected by the First Amendment of the Constitution of the United States of America.

Amendment I

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

This is the Code of Ethics used to guide the news media in the exercise of their work.  Do you think they are following their own Code of Ethics?

SPJ Code of Ethics


Members of the Society of Professional Journalists believe that public enlightenment is the forerunner of justice and the foundation of democracy. Ethical journalism strives to ensure the free exchange of information that is accurate, fair and thorough. An ethical journalist acts with integrity.

The Society declares these four principles as the foundation of ethical journalism and encourages their use in its practice by all people in all media.

Seek Truth and Report It

Ethical journalism should be accurate and fair. Journalists should
be honest and courageous in gathering, reporting and interpreting

Journalists should:

Take responsibility for the accuracy of their work. Verify information before
releasing it. Use original sources whenever possible.

Remember that neither speed nor format excuses inaccuracy.

Provide context. Take special care not to misrepresent or oversimplify in
promoting, previewing or summarizing a story.

Gather, update and correct information throughout the life of a news story.

Be cautious when making promises, but keep the promises they make.

Identify sources clearly. The public is entitled to as much information as possible
to judge the reliability and motivations of sources.

Consider sources’ motives before promising anonymity. Reserve anonymity for
sources who may face danger, retribution or other harm, and have information
that cannot be obtained elsewhere. Explain why anonymity was granted.

Diligently seek subjects of news coverage to allow them to respond to criticism
or allegations of wrongdoing.

Avoid undercover or other surreptitious methods of gathering information
unless traditional, open methods will not yield information vital to the public.

Be vigilant and courageous about holding those with power accountable.
Give voice to the voiceless.

Support the open and civil exchange of views, even views they find repugnant.

Recognize a special obligation to serve as watchdogs over public affairs and
government. Seek to ensure that the public’s business is conducted in the
open, and that public records are open to all.

Provide access to source material when it is relevant and appropriate.

Boldly tell the story of the diversity and magnitude of the human experience.
Seek sources whose voices we seldom hear.

Avoid stereotyping. Journalists should examine the ways their values and
experiences may shape their reporting.

Label advocacy and commentary.

Never deliberately distort facts or context, including visual information.

Clearly label illustrations and re-enactments.

Never plagiarize. Always attribute.

Minimize Harm

Ethical journalism treats sources, subjects, colleagues and members of
the public as human beings deserving of respect.

Journalists should:

Balance the public’s need for information against potential harm or discomfort.
Pursuit of the news is not a license for arrogance or undue intrusiveness.

Show compassion for those who may be affected by news coverage. Use
heightened sensitivity when dealing with juveniles, victims of sex crimes,
and sources or subjects who are inexperienced or unable to give consent.
Consider cultural differences in approach and treatment.

Recognize that legal access to information differs from an ethical justification
to publish or broadcast.

Realize that private people have a greater right to control information about
themselves than public figures and others who seek power, influence or
attention. Weigh the consequences of publishing or broadcasting personal

Avoid pandering to lurid curiosity, even if others do.

Balance a suspect’s right to a fair trial with the public’s right to know. Consider
the implications of identifying criminal suspects before they face legal charges.

Consider the long-term implications of the extended reach and permanence of
publication. Provide updated and more complete information as appropriate.

Act Independently

The highest and primary obligation of ethical journalism is to serve
the public.

Journalists should:

Avoid conflicts of interest, real or perceived. Disclose unavoidable conflicts.

Refuse gifts, favors, fees, free travel and special treatment, and avoid political
and other outside activities that may compromise integrity or impartiality,
or may damage credibility.

Be wary of sources offering information for favors or money; do not pay for
access to news. Identify content provided by outside sources, whether paid
or not.

Deny favored treatment to advertisers, donors or any other special interests,
and resist internal and external pressure to influence coverage.

Distinguish news from advertising and shun hybrids that blur the lines
between the two. Prominently label sponsored content.

Be Accountable and Transparent

Ethical journalism means taking responsibility for one's work and
explaining one’s decisions to the public.

Journalists should:

Explain ethical choices and processes to audiences. Encourage a civil
dialogue with the public about journalistic practices, coverage and news

Respond quickly to questions about accuracy, clarity and fairness.

Acknowledge mistakes and correct them promptly and prominently. Explain
corrections and clarifications carefully and clearly.

Expose unethical conduct in journalism, including within their organizations.

Abide by the same high standards they expect of others.

The SPJ Code of Ethics is a statement of abiding principles supported by additional explanations and position papers (at spj.org) that address changing journalistic practices.

It is not a set of rules, rather a guide that encourages all who engage in journalism to take responsibility for the information they provide, regardless of medium. The code should be read as a whole; individual principles should not be taken out of context. It is not, nor can it be under the First Amendment, legally enforceable.

Establishment Democrats and News Media still do not get it as Trump juggernaut buries them in Chaos


One day, most likely far into the future, the American Democratic party and the national news media may step back and say, "what did we do wrong?" as Trump is finishing his second term as President of the United States.

You see, the news media, liberal world, and to some extent the conservative world in the USA find each other in the midst of a non-stop political maelstrom and the source of the political potpourri is none other than the most unlikely president in our history, Donald Trump.

All of these potential enemies of our new president share a few common bonds called conceit, arrogance, elitism, a holier than thou attitude, and a serious lack of historical knowledge and common sense.

"MSNBC Is 'Shocked' That Donald Trump Followed Through on His Campaign Promises"

As a result, they fail to understand that President Trump is not of the same mold, cloth, or temperament of any of them.  Oh, he graduated from an Ivy League School, Wharton, but he did not receive the same indoctrination those other elitists absorbed.

No, President Trump learned the game of life and survival in the school of hard knocks, the streets of New York City, where winners survive and losers just disappear.  In my years in New York and New Jersey, after growing up in the Midwest and college in Arizona, I came to understand the incredible disenfranchisement between the grass roots American and the eastern elitist.

In the Midwest, public service was an honorable activity but was seldom a career.  Out East, the political parties and politicians tried to make it a dominant force over society.  Money ruled the hallways of government out East while patriotism ruled in the Midwest.

Call it an attitude, a superiority complex, or putting on airs, as far back as the 1960's it was well established and obvious and the result was those out East took themselves far more seriously than the typical Midwestern American.

When I traveled more extensively over the years, I noticed the same detachment between the East and South, Great Lakes, and Southwest.

All the while, the political and news media elitists out East became more alike than dissimilar except over a few basic issues while becoming more and more ideologically polarized.  Political party platforms became a joke never to be seriously pursued once one was elected president.

Among the greatest mistakes of the elitist politicians and news media are they continually underestimated the knowledge and wisdom of Americans outside the Northeast corridor, the area from Washington, DC to Boston where 54 million people live.

Long ago, the silent majority of Americans saw the growth of money and corruption in politics and government.  As the two political parties fought it out for the minds and votes of Americans, the people were deserting the parties in record numbers.

So dramatic was this ignorance by the elitists they did not notice in 2016 when for the first time in our history there were more voters registered as Independents than either Democrats or Republicans.  Even more ominous for the elitists, almost 50 percent of the eligible voters did not even register to vote.

For those pollsters and political pundits too blind to see the truth, that means nearly two-thirds of all the eligible voters in America were fed up with the political system as presented by the news media and two political parties.

At the very same time the polarization in politics and the parallel rise of ideological bias in the news media caused a disastrous collapse of trust in that most sacred of US protected classes, the news media.  By the time the 2016 election was in full swing, just six percent of the public trusted the news media.

"Is the Liberal Media Trump trashing finally over, or is it now destined for oblivion?"

Again, for the benefit of the brain dead media and pundits who failed to read the tea leaves, that means ninety-four out of every one hundred Americans did NOT trust the news media.  Yet the media arrogance continued to grow as they tried to project their bias into all aspects of reporting and Trump was the target of the growing venom of the media.

Donald Trump sensed this frustration, dissolution, and disgust of the forgotten Americans that was accelerating as the Obama years ground to an end and once again, the agenda of another political leader had failed to materialize.

Here is the real news Trump was not an ideological candidate.  Trump was not a politician.  Trump was not even a real Republican.  He was not interested in being politically correct and he sure hated the status quo.  Because he was rich, he did not need to sell his body and soul to the financially powerful.  Each of these characteristics made him more and more valuable to the vast and growing silent majority.

In the end, the vast majority of the people who voted to elect Trump did not vote for Donald Trump, they voted for a voice, an ear, a doer, an outsider, a disrupter, a person who just wanted to make America Great Again.

Whether he registered as a Republican or Democrat mattered not because he was certain to alienate anyone standing for the status quo, for preserving the establishment, for accepting the dominant rule of political parties, or one who catered to the needs of a needy news media.

People did not have to like him to vote for him, they just had to believe he would fight for change, disrupt the Establishment, and in the end fix the many problems now facing our nation.

Donald Trump understood his strange bond with the silent majority where a billionaire becomes the ombudsman for the ignored masses.  There are no favorites in Trump's worldview, only those willing to play.

Trump believes in a world that leaves no one behind.  That including those many voters lied to and mislead by the political parties over the years.  Trump recognizes everyone is a victim of a failing political system and a biased news media establishment.
The Trump juggernaut is dominating the establishment politicians and news media because they insist on playing by their own rules (he does not), and because urgency is not a part of the bureaucratic way in our nation's capitol.  President Trump, on the other hand, thrives on action and chaos.

One day the politicians and news media may realize that Trump is not the favorite, but is certainly the chosen, to do what American citizens believe is necessary to save our American institution.