Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict

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HIPPOCRATIC, RELIGIOUS, AND SECULAR MEDICAL ETHICS: THE POINTS OF CONFLICT. By Robert M. Veatch. Washington: Georgetown University, 2012. Pp. xiii + 242. $29.95.

Veatch successfully provides a critical reading of the Hippocratic Oath in medical ethics. His volume, however, is more ambitious. Developing his 2008 Gifford Lectures on the ethics of medicine, he explores the relationship of professional medical ethics to the religious and secular sources of ethical reasoning and praxis.

On the one hand, V. challenges medical ethics by stressing the incompatibility of the Hippocratic approach with today's medical practice and ethics. The Hippocratic Oath was the expression of a very particular philosophical group (Pythagorean-like); it resembles an initiation rite; it is highly paternalistic and individualistic; and it ignores the contributions of religious and secular ethics in articulating rights, duties, and norms. Hence, it should not be considered the foundation of medical ethics (chap. 1). V.'s historical study (chap. 2) is quite selective and interesting--despite not referring to Albert Jonsen's insightful Short History of Medical Ethics [2000]--and it stresses the weak presence of the Oath throughout the centuries. Moreover, V. emphasizes how the Oath's reemergence in the 19th-century American professional codes coincides with the loss of the humanist critical perspective.

On the other hand, V. is critical of professional ethical codes in medicine on two grounds: first, the sources of ethical norms are outside the profession (88) and are expressed and articulated within religious and secular traditions; second, professional medical codes are written without the patients' involvement, betray corporative interests and narrow ethical perspectives, and are not helpful in addressing complex issues that concern physicians--as in the case of nutrition and hydration, capital punishment, and surrogate motherhood (chaps. 3-5). V. argues for a more inclusive normative approach. This is exemplified, first, by the 1997 European Convention for Human Rights and Biomedicine proposed by the Council of Europe and currently signed, ratified, and implemented by 29 European countries; second, by UNESCO's 2005 Universal Declaration on Bioethics and Human Rights (chap. 7).

For V., a professional organization is charged only with certifying professional competency and not with articulating its ethical standards. "Society" should determine these standards (96). Hence V. discusses the contributions of religious and secular sources in shaping medical ethics (chaps. 5-7). In doing this, he fulfills the mandate of the Gifford lectures, which were established by Lord Adam Gifford to promote the study of natural theology, the knowledge of God in light of human reasoning. …