C-The shift from humanity to commerce:
Unfortunately, when the medical profession grew larger and larger, it started to take a more commercial aspect. Doctors started to collect fees from patients, treat patients as a case not as human beings, disregard the patients psychological condition, and not paying attention to the patient's individuality. Patients are now more like subordinates to doctors and patients have no right to argue with a doctor diagnosis or opinion, otherwise the patient would be considered a defect.
D-The code of medical ethics:
Despite all what has been said above, there is still an ethical issue involved in the medical field and there's a code of ethics among doctors that is considered a backup to the Hippocrates oath.
D.1-Medical Ethics
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The Principles of Medical Ethics are living, dynamic precepts that profoundly influence the interaction between patient and physician.
Written to proclaim standards of conduct and ethical behavior identified and adhered to by physicians dating back as far as the Hippocratic Oath, the Principles of Medical Ethics set forth the basic moral tenets for the medical profession. These universal precepts are then interpreted and applied to new situations and protocols as they arise over time.
The AMA (American Medical Association) Principles of Medical Ethics are a potent, vigorous contract of caring between physicians and patients. Commitment to these Principles distinguishes AMA physicians from all the others, and instills confidence in patients.
Principles of Medical Ethics
- A physician shall be dedicated to providing competent medical service with compassion and respect for human dignity.
- A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.
- A physician shall respect the law and recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
- A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.
- A physician shall continue to study, apply, and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talent of other health professionals when indicated.
- A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose
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serve, with whom to associate, and the environment in which to provide medical services.
VII.A physician shall recognize a responsibility to participate in activities contributing to an improved community.
Source: Code of Medical Ethics: Current Opinions with Annotations © 1996 American Medical Association
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Chapter 2
The Hippocrates oath and its applications in the contemporary world of medicine.
A-Who is Hippocrates?
Hippocrates, (377-460 BC), he is an extraordinary medical writer of Greece. Little is known of his life beyond the fact that he was a physician on the island of Cos that he belonged to the most intellectual period of Grecian life, and that Hippocrates was singularly free from superstition. Over eighty treatises have been attributed to him. Hippocrates has been called the father of scientific medicine. He did not believe in miraculous diseases or cures. He taught that proper diet is a necessity of health, and that climate has a profound influence on both mind and body. He died in Thessaly at an advanced age. Hippocrates is mostly known for his oath which is still taken by new doctors till these days.
B-The Hippocrates oath:
" I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not
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cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!"
(400 BC THE OATH by Hippocrates Translated by Francis Adams)
As shown above this oath stresses on the ethical aspect of the medical profession, the doctor swears that he will practice his career with most dignity and decency. This oath commits the doctor to treat patients with clear conscious and never give any medicines which harm any person and never perform abortion surgeries etc…..
C-How much the Hippocrates oath is practiced today?
Taking in consideration the circumstances of the medical industry in the world in general, we find a major trend to consider the profession of medicine as a commercial profession rather than a humane one practiced by a man to help a fellow man overcome a disease. Although the Hippocrates oath is still performed until the current time by all the newly graduated doctors without ay exception, most of those doctors do not commit to that oath. They consider their profession as a gateway to fame and financial security disregarding the humane aspect of their job. This problem is worldwide; however, the United States has the biggest anti-commercialization of the medical profession movement. Just like Ralph Nadir who was the first man to
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defend consumer rights, Dr. Hunter "Patch" Adams was the first who defended the patient's rights as a human being and not as a medical case. The Patch Adams story will be discussed in the next chapter.
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Chapter 3
A-Who is Patch Adams?
Hunter Adams is an American doctor who changed the way doctors treated patients in the USA. During the late sixties Adams was a young lost American who was deeply put down by the way he lived his life. He had no idea about what to do with his life and nothing made sense to him. After a while, he checked himself in to a mental hospital because he could not endure the life outside. In the mental hospital Adams found his mission in life. He realized that if anyone wants to forget about their problems they should think about helping others solving their problems. Hence, he decided to study medicine and become a doctor so he could help the most in need which are patients because "The loudest cry of patients was for compassion and attention which was a call for time "(The Gesundheit institute www.patchadams.org). After getting out of the hospital "Patch", as called by one of the patients in the hospital, joined the medical school where he had a great ambition to become the best doctor the world had ever known. In college, and since being a radical student and revolutionary person who wanted to change everything around him especially the way doctors treated patients in the university hospital, Patch Adams faced a lot of rejection and mistreatment from his teachers, and he was threatened to be suspended more than once. But despite all that the famous Patch Adams graduated as a fully ambitious doctor in the early seventies.
B-The Patch Adams Effect on the American medical field.
If you look at the changes that occurred in the doctor-patient relationship in the past few years, you'll notice a great different. Doctors now are obliged to respect the patient as an equal person who has feelings and need that should
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be taken into consideration. A whole new word emerged among doctors that hadn't been known before. It is the "Quality of life" now doctors give major consideration to the quality of the patient's life rather than just his medical condition. Although this issue is still controversial, people are starting to believe that medicine is not just about prolonging life, it's also about improving it and as Robin Williams said as the great Patch Adams: "when you treat a disease you might win or you might lose; but when you treat a person I can guarantee you, you'll win no matter what the outcome is" .
Patch Adams was a pioneer in reorienting the medical profession into its original goal which means a purely humane profession, his resolve and bravery changed the way America felt about doctors. A doctor is now more as a friend not just a therapist.
C-The Patch Adams Movie and the coming to fame.
Before 1999 no one knew the full story of Patch Adams. He was known among doctors on a small level. However, after the movie came out and hit very high, everybody inside and outside USA knew Patch Adams and his contribution to the rights of patients to be treated as persons. The film was starring Robin Williams and Monica Potter and was directed by Tom Shadyak. All the revenues from the movies were devoted to the construction of the new building of the Gesundheit hospital.
D-The Gesundheit hospital.
Gesundheit is a German word which is used as a "bless you" after a sneeze. But Gesundheit is also the name of the hospital Patch Adams founded in 1972. while he was at college, Patch Adams was very upset about what was happening in the hospitals in the US back then, so he decided to start the spark of change. He borrowed a small piece of land and built a small house on it. He used this house to receive patients as a clinic, however it was far from being a conventional clinic. Gesundheit was a place where everybody
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(doctors and patients) were equal, no one is better than anyone. If you needed to clean a wound, if you had a fever, if you needed to talk, help, laugh or do anything that made you feel better, you could go to Gesundheit a nice warm place where you can find laughs, friendship, warmth just as much as medical treatment. The clinic services were free of charge on the condition that you participate in wit everyone. This was a very good idea and many people liked it, but it almost had Adams suspended from school on the basis that he practiced medicine without a license. After Patch graduated, he ran his clinic with the same concept and doctors from around the world volunteered to be part of the Gesundheit team. However, it stayed a small clinic in West Virginia until the movie came out based on the book written by Patch and obviously called Gesundheit. After the movie the clinic grew into a 6000 square foot area and the dream hospital is currently under construction.
The Gesundheit mission and vision:
To bring fun, friendship, and the joy of service back into health care.
The Gesundheit! Institute is dedicated to upholding a radical socio-political vision replacing greed and competition with generosity, compassion and interdependence.
1. as a stimulant to broaden the health care delivery dialogue, Gesundheit! Institute’s mission is to build a hospital/healing community and provide care based on these principles:
- All the healing arts are welcome
- All patients are treated as friends
- There is no charge for health services
- No third party reimbursement is accepted
- The health care experience is infused with fun
- No malpractice insurance is carried by the Institute
- The health of the staff is valued equally with the health of the patients
- The health of an individual is nested in the health of family, community, society and the natural environment
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2. We seek to stimulate caring by encouraging grassroots, neighborly mutual support and personal activism through:
- Lectures, workshops and presentations around the world
- Nasal (clown) activism
- House Calls Program: Doing it together!
- Exploration of Costume Therapy as a model of developing personal activism
- Maintain a neighborly presence in Pocahontas County
3. We aim to animate community health responsibility by assessing community health needs and resources, mobilizing and inspiring a right relation between these, and nurturing a snowball effect of activism that supports sustainability of individual and community health.
- Active participation in the development of the “Rainbow Valley Community Health Centre” in Killaloe, Ontario, Canada
4. Pioneer, through research, the understanding of the implications of the healthy interdependence of personal activism, mutual support, vibrant community and world peace.
- Conferences to bring together fun, creative, compassionate health pioneers
- Nurturing activists
(From http://www.patchadams.org/about_gesundheit/mission_vision.htm)
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Chapter 4
A-The health care system in Lebanon.
The Lebanese medical field is one of the most advanced in the middle east. Hence, a lot of Arabs especially from the gulf come to Lebanon in what they call a medical tourism trip which means they come seeking a treatment as well as a vacation. Lebanese doctors when it comes to competency are very competent and are very notorious in the world especially in the US like Dr. Michael Dabaghy who is the best cardiologist in the US and Dr. Philip Salem head of the cancer department in the Houston general hospital.
Lebanese hospital are mostly advanced and well equipped. The AUH, Hotel Dieu, and others are good examples of the highly advanced Lebanese hospitals.
D-The patient in the Lebanese medical system.
Despite the advanced medical field in Lebanon, it is far behind when it comes to patients' rights. The patient in the Lebanese medical system is always suppressed and persecuted. A Lebanese patient is a weak person who should obey without argue the doctor's order and the patient has no order to question any doctor's performance.
Although the Lebanese law gives the patient the right to sue doctors for malpractice, not a single case is registered to have convicted a doctor who didn't perform his job with good conscious.
Sometimes hospital commit awful crimes at the excuse that the patient didn't pay the fees "A Lebanese hospital refuse to let a mother see her new born before paying the fees" (Assafir newspaper 2003 ).
Lebanese doctors are far from being humane, all they care about is fame and money and the patient is not even on the list of their priorities. The quality of life is not in the dictionary of the Lebanese medical system.
D-A good step to the future
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Despite all the misery, there a little bit of hope that someday Lebanese doctors will start to respect patients' needs. The AUH hospital has taken a good step toward this goal by holding training sessions for all doctors and nurses to teach them how to be nicer to patients and how to understand the patient. But what we need more is a Lebanese Patch Adams who defies all the odds and triggers the spirit of change.
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Chapter 5
Concluding and assessing the study by suggesting solutions to problems addressed.
There few things that people can't live without: food, beverage, shelter, and medical treatment. A doctor is a very important person and from that particular concept, a doctor should realize that everyone needs him which gives him more responsibility not more privilege.
The medical field has come a long way since the day of sorcerers and magicians, but despite all that the medical field especially in Lebanon needs a lot of improvement when it comes to the doctor-patient relationship. Medicine is a human science, and with the word human come the word, mercy, tolerance and sympathy. That what exactly lack the medical profession. Also with the word human comes the best word which will make us hold on pretty well the word is "hope".
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Works Cited
Adams, Hunter, P. Patch Adams diary. Sept 2003. 20 May 2004.
< >
Adams, Hunter,P. The Gesundheit Hospital Mission. Sept 2003. 20 May 2004
<http://www.patchadams.org/about_gesundheit/mission_vision.htm>
American, Medical Association, Code of Medical Ethics: Current Opinions with Annotation, American Medical Association 1996.
Anonymous, "A hospital refuses to let a mother see her newborn", Assafir newspaper, 2004.
Hippocrates. The Oath. 400 B.C. trans. Francis Adams, 1996.
