To suggest that one cannot or should not defend the sanctity of human life in the public square by using publicly accessible secular language is to remove a necessary tool for making the case for valuing and protecting all human life. While religious arguments are good and necessary even in the public square, secular arguments from reason are equally as important for effectively engaging in the marketplace of ideas in a pluralistic society. If we deny secular reasoning, then we deny thousands of years of the rich Hippocratic tradition in medicine. For in fact Hippocrates and his colleagues were pagan. Dust off the oath and read it.
The Hippocratic Oath divides into two parts—the oath and the covenant. In the oath, the physician swears (to a list of pagan gods) his allegiance to his teacher, who is equal to his parents, and pledges to share his knowledge with others who have also signed the covenant. The covenant part of the oath establishes the professional obligation to practice medicine to a standard far greater than just “doing what the patient asks.” In summary, the obligations are:
1. To give optimal care to the sick and to never injure or wrong them—a concept often summarized by the term “do no harm” (“I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them”);
2. To never assist in suicide or practice euthanasia, nor suggest it (“I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan”);
3. To never perform an abortion (“and similarly [to giving a lethal drug], I will not give a woman a pessary to cause an abortion”);
4. When one does not have sufficient expertise (there was a clear demarcation between physicians and surgeons in ancient medicine), to refer to a practitioner who does (“I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft”);
5. To treat all patients as equals (“avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves”);
6. To never have sex with patients (“avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves”);
7. To maintain patient confidentiality (“Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private”) (1).
Hippocrates and his contemporaries understood the idea of the sanctity of human life and the dignity of human persons, or as Wesley J. Smith writes, the idea or ideal of human exceptionalism. The Hippocratic belief of primum non nocere—first, do no harm—was the guiding principle in the covenantal directives which flowed from it. No euthanasia, nor even the thought of suggesting it, even if asked. No abortion. Equal treatment for all one’s patients along with the command of proper conduct, which protects the physician-patient relationship. Why? Because of the belief in human dignity and the sacredness of each and every human life. These concepts are known and understood by those in the secular world as well as those in the major religions. While tucked away from many people’s minds, the sensibilities of the oath are still very much with us. Yes, they are eroding, but they can easily be resurrected and put into practice when we make our arguments in the public square. This is something I often do in my work, and it has been quite effective in making the case for the sanctity of human life. Let me offer a few illustrations of how this works out in everyday life.
Physician Assisted Suicide (PAS)
The arguments put forth in support of PAS (or as supporters call it, Physician Aid in Dying) are rooted in personal autonomy and choice, and in rights and freedom. It is a secular defense for the right of individuals to decide, if and when their suffering becomes too great to bear, to end their lives by requesting from their physician a lethal prescription. Arguments against this practice from a strictly religious point of view often fall on deaf ears and have not proven effective. “God is the author of life, the creator of and the decider of our days.” “Suffering is instructive in producing character and virtue as in the life of Job.” These are true claims by those who share an orthodox Judeo-Christian view, but are often meaningless arguments in the public square.
On the other hand, a secular argument against PAS can be powerful and effective, offering a chance to poke holes in the pro-PAS position and demonstrating how detrimental legalized PAS can be. For example, Oregon’s Death with Dignity Act “allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose” (2). Without drumming up absurd stories, it is not difficult to come up with cases of extreme suffering without terminal illness. So if this practice is about Oregonians voluntarily choosing to end their lives, why is it restricted only to those suffering from terminal illness? Who is the state of Oregon to push its restrictions on my personal autonomy and right to die?
The actual act is instructive. It is a 12-page document of rules and regulations stating who can sign up for a lethal prescription and how to go about doing so. These rules and regulations create many impediments to one’s “right to die.” Waiting periods, verbal and written requests, notifications, witnesses, etc., are examples of required practices. In order to mitigate “abuses,” pages of safety measures must be put into place. Perhaps revisiting why Hippocrates was adamant about the need to “do no harm”—to never practice euthanasia and to treat all patients as equal and with utmost respect—is in order for those in the public square arguing for the maintenance and nurture of the covenantal bond between physician-as-healer and patient.
From the French word trier, which means “to sort,” triage is a system implemented in France during World War I by physicians who were treating the wounded and needed to quickly assess and prioritize cases. This system is still practiced today all around the world, in hospitals, war zones, and with emergency medical providers. The foundational principle is that all patients are equal and of value. From there, they are sorted into categories of medical need as it relates to injury or illness. Triage depends on and functions within the Hippocratic tradition of “first, do no harm”—treat all patients as equal, practice within an area of medical expertise, and make referrals to specialists. If you visit a busy inner-city emergency room today, you will witness healthcare professionals administering care based on medical need, the Hippocratic tradition of “first, do no harm,” and seeing all people as equal and deserving of care.
While appeals to a faith tradition can be powerful and life-changing, we need a multitude of strategies to persuade and convince the larger culture that all human life is of equal intrinsic worth and that we need to enact policies which protect and serve human life. Secular documents like the Hippocratic Oath and even the more modern Universal Declaration on Human Rights acknowledge the dignity and rights of human beings and are useful and instructive to accomplish those ends.
1. Taken from “Rights of Conscience for Health Care Providers,” a project by the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), commissioned in conjunction with Jennifer Lahl, R.N., M.A.; Wesley J. Smith, J.D.; Evan Rosa, The Center for Bioethics and Culture; and AAPLOG.
2. The Oregon Death with Dignity Act, Oregon Revised Statutes (PDF)