Wednesday 31 January 2018

THE LEGAL IMPLICATIONS OF THE 2017 PHYSICIAN'S PLEDGE

THE LEGAL IMPLICATIONS OF THE 2017 PHYSICIAN'S PLEDGE

The Hippocratic Oath is the worldwide oath administered to the medically qualified persons in almost all the countries of the world as they are ushered into the practice of the medical profession. This oath was said to have come into existence from the time of Hippocrates,  reputed to be the father of medicine. However, the modern oath was only adopted in 1948 as an international code of medical practice.

This oath had been adapted by some countries while other countries used the oath without modification. Yet a few others make their own oath.

The oath has been variously altered in different periods of history to suit changing tides in medical practice. The Hippocratic Oath,  now called Physician’s Pledge, was first adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland, September 1948 and amended by the 22nd World Medical Assembly, Sydney, Australia, August 1968, and the 35th World Medical Assembly, Venice, Italy, October 1983, and the 46th WMA General Assembly, Stockholm, Sweden, September 1994, and editorially revised by the 170th WMA Council Session, Divonne-les-Bains, France, May 2005, and the 173rd WMA Council Session, Divonne-les-Bains, France, May 2006, and the WMA General Assembly, Chicago, United States, October 2017.

Below is the anatomy of the 1948 Geneva Physician's Oath:

I solemnly pledge myself to consecrate my life to the service of humanity;
I will give to my teachers the respect and gratitude which is their due;
I will practice my profession with conscience and dignity;
The health of my patient will be my first consideration;
I will maintain by all the means in my power, the honor and the noble traditions of the medical profession;
My colleagues will be my brothers;
I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
I will maintain the utmost respect for human life from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity;
I make these promises solemnly, freely and upon my honor.

Next is the Nigerian version as adapted from the Geneva Physician's' Oath:

I SOLEMNLY PLEDGE to consecrate my life to the service of humanity;
I WILLGIVE to my teachers the respect and gratitude which are their due;
I WILLPRACTISE my profession with conscience and dignity;
THE HEALTH OF MYPATIENTWILLBE my first consideration;
I WILL RESPECT the secrets which are confided in me, even after the patient has died;
I WILL MAINTAIN by all means in my power the honour and the noble traditions of the medical (dental) profession;
MY COLLEAGUES will be my brothers and sisters;
I WILL NOT PERMIT considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
I WILL MAINTAIN the utmost respect for human life from the time of conception; -
Even under threat, I WILLNOT USE my medical knowledge contrary to the laws of humanity
I MAKE THESE PROMISES solemnly, freely and upon my honour.

Then, the 2017 newest Physician's Oath, renamed THE PHYSICIAN'S PLEDGE:

AS A MEMBER of the medical profession:
I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;
THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;
I WILL RESPECT the autonomy and dignity of my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing, or any other factor to intervene between my duty and my patient;
I WILL RESPECT the secrets that are confided in me, even after the patient has died;
I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;
I WILL FOSTER the honour and noble traditions of the medical profession;
I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;
I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;
I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
I MAKE THESE PROMISES solemnly, freely, and upon my honour.

The new oath has far-reaching implications on the doctor, the patient and the society. These implications mean that the Medical and Dental Council of Nigeria has been significantly limited on the scope of punishment it can mete out to doctors. The only way a doctor can be punished in those areas limited is where a doctor violates a criminal law. The general law is applied to him. His act or omission cannot therefore be seen as unethical, or his licence placed in jeopardy of withdrawal, or his name placed at risk of being struck off.

I must quickly rush to acknowledge that the World Medical Association (WMA) has just once more come to the rescue of the Nigerian doctors, and other doctors from other less privileged countries. Strikes are now ethical. Respect for junior doctors are now ethical obligation. A patient desire is now an indication for procedures hitherto denied patients. The utmost respect for human life from the time of conception, has been restricted to the utmost respect for human life. The command not to use medical knowledge contrary to the laws of humanity, was modified to mean the non use of medical knowledge to violate human rights and civil liberties. The maintaince by all the means in the doctor's power, the honor and the noble traditions of the medical profession; was changed to the fostering of the honour and noble traditions of the medical profession.

This new oath has done revolution on the archaic ideas of some medical elders in Nigeria who have always seen professional respect as a one-way traffic. Now, restriction on abortion is out, respect for students and homosexuality in, indecent relationship with patient is out, doctors welfare in, patient autonomy to use their life in, patient compulsory welfare now narrowed to the mother and excludes intrauterine gestation.

Those Nigerian doctors in America who have their licences removed because of seduction from their female patients will possibly breath again.

Now, this oath has automatically become our medical ethics. It has become our integral code. It is conceded that the new Pledge may not yet be recognized by the Nigerian Courts until the MDCN has altered our Code of Medical Ethics of 2008 to reflect this great departure from the old Oath, which is broadly inscribed in the current Nigerian Medical Code like an albatross.

©Awkadigwe Fredrick 2017
awkadigweikenna@yahoo.com


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© Copyright 2017 Ikenna Fredrick Awkadigwe. All rights reserved. No part of this publication is permitted to be used in any way, copied, photocopied printed, reproduced, transferred, adapted, argued in any fora, used in Court or recreated in any form or resemblance whatsoever, without the written approval and license of the author, Ikenna Fredrick Awkadigwe.

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