In Search of the Modern Hippocrates
"Richard Bulger is one of the most articulate and effective spokesmen for resisting the pressures that seem to be pushing us toward a medical establishment that is primarily an industry…This book should be on the reading list for every course in the humanities and medicine."—The Pharos
"A thought-provoking book for all students of the doctor-patient relationship."—New England Journal of Medicine
The ancient Hippocratic oath that every doctor pledges upon graduation from medical school is a code based on genuine devotion to people and a desire to serve them. It is also a code in urgent need of updating to reflect the technological and moral changes of modern society and the complicated dilemmas facing every practicing physician.
This collection of essays by some of the wisest observers of modern medicine probes the various forces affecting health care today: the power of the new technology in diagnosing and treating illnesses, the growing appreciation of mind/body interactions, the emergence of corporate hospitals and health care centers, and, most importantly, the essence of physicianhood—what makes a doctor want to practice medicine.
In considering these issues, the essayists question whether the medical-industrial complex will destroy physicians as we know them, making doctors employees of large profit-making institutions and more responsible to their companies than to their patients. Will increasing versatility in technological medicine remove doctors even further from the patient's bedside, weakening the diminishing bond between patient and doctor? Are there points of contact between western "scientific" medicine and holistic practices? Is there a place in modern medicine for work therapy and the placebo effect?
Each of these issues prevalent in medicine today has, in its own particular way, an effect upon the core relationship between doctor and patient. In Search of the Modern Hippocrates is dedicated to the premise that current changes in medicine can produce an altered and strengthened medical profession resolved to preserve the inextricable link between commitment and care. Ending with the development of a modern oath of ethics, it provides an important guide to medicine in the complex world we now face.
Part I. The Need for Direction
1.The Modern Context for a Healing Profession: Revolutionary changes, turbulence, and confusion—can any good come of them? by Roger J. Bulger
2. The Search for a New Ideal: Reflections on the oath and personal quests for meaning and usefulness by Roger J. Bulger
Part II. History Philosophy, Ethics, Psychology, and Values Essential to Physicianhood’s Core
3. Hippocrates and History: The Arrogance of Humanism: Some history and philosophy related to Hippocrates by Dickinson W. Richards
4. Toward an Expanded Medical Ethics: The Hippocratic Ethic Revisited: A modern updating of individual and corporate ethics essential to phsyicianhood by Edmund D. Pellegrino
5. The Golden Rule and the Cycle of Life: An analysis of trust and mutuality bearing upon the nature of a mature healing relationship by Erik H. Erikson
6. Narcissus, Pogo, and Lewis Thomas’ Wager: A view of the values with which doctors and patients must deal by Roger J. Bulger
7. On the Drinking of the Hemlock: Socrates, Semmelweis, and Barbara McClintock: On the essential nature of integrity and honesty for medicine and science and the difficulty of living up to such absolute standards by Roger J. Bulger
8. Emerging Unities of the Twenty-first Century: Service as Sacrament, Emotional Neutrality, and the Power of the Therapeutic Word: An interpretive view of recent intellectual trends which encourages a new unitary expression of the art and science of medicine in an approach to healing
by Roger J. Bulger
Part III. The Healing Context: Cultures, Persons, and Words
9. The Anthropology of Healing: An analysis of the variety of impacts cultures can have on perceptions of disease, healers, and actual outcomes of treatments by Lola Romanucci-Ross and Laurence R. Tancredi
10. The Lost Secret of Ancient Medicine: The essence of healing rediscovered by Guido Majno
11. Thomas Merton the Healer: A healer by any other name is still a healer by Robert Coles
12. Words as Scalpels: Transmitting Evidence in the Clinical Dialogue: Therapeutic tools can also produce adverse reactions and toxic side effects—words are no exeception by Stanley J. Reiser
13. Placebos, Patients, and Physicians: How words can heal in some instances, and maybe absolute truth is harder to determine than many physicians think by Howard M. Spiro
14. Lying: It is never right to alter the truth—do Spiro and Crawshaw really disagree? by Ralph Crawshaw
Part IV. The Future for Physicianhood
15. The Future of Medical Practice: A medical-industrial complex dominated by corporate entities may rule American medicine—what will that mean to the essence of doctoring? by Arnold S. Relman
16. Technology and the Eclipse of Individualism in Medicine: Modern technology will alter the face of medicine even more than it already has—will there be no room for a human being to serve as healer or facilitator for healing? by Stanley J. Reiser
17. The Humanities and the Arts in Medical Education: Is there any way to promote greater learning and insight into the nonscientific, nontechnical dimensions of life for the physician? The answer is yes. Are these other aspects essential to the core of the physician? The answer is yes. by Roger J. Bulger
18. A Postscript from the Physician as Patient: Some Observations on Having a Coronary: An important insight into modern health care by David E. Rogers
19. A Dialogue with Hippocrates and Griff T. Ross, M.D.: We need a new oath and Hippocrates, who never wrote one before (see chapter 3), offers one for the twenty-first century by Roger J. Bulger
Notes on Contributors