Nothing but the Tooth column: Living up to the Hippocratic Oath

Dr. Richard Greenberg
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Taft Midway Driller

Columns share an author’s personal perspective.

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This week, my column is going to take an op-ed approach. There will be no questions or answers. I came to this conclusion after reading an op-ed piece in the New York Times, dated Dec.14, and written by Dr. Richard A. Friedman, of Weill Cornell Medical College.

The thrust of the article that struck me most was Dr. Friedman’s thoughts regarding the immense responsibility that doctors have in regard to statements made to the public. It has been ingrained in our population, rightfully or wrongfully, that the words emanating from a doctor are always to be taken on face value. “The doctor is always right” (NOT ALWAYS).

Indeed, as Dr. Friedman points out, some of what our country has heard from medical professionals in the past months has been blatantly incorrect, ultimately leading to the deaths of thousands of our population. I believe a number of these statements to be completely false as does Dr. Friedman. Dr. Friedman even goes to the extent of calling upon state health commissions to consider sanctions on these individuals and other punitive actions.

These errors of fact and errors of judgement have much more of a profound effect on society and a much more wide-reaching effect than similar errors made in my field of dentistry. Nevertheless, I am still as passionate about them when they are made in dentistry as Dr. Richard A. Friedman is about those made in medicine.

Those of us in Medicine and Dentistry recite the “Oath of Hippocrates” upon receiving our degrees. There are many versions of this oath, both classic and modern. One of the oldest binding documents in history, the oath written by Hippocrates is still held sacred by all health professionals. For this reason, I have included a version of the oath below that I and my colleagues recited prior to receiving our degrees. I hope each of you will read it carefully to understand more clearly our objectives in treating our patients.

Words to live by

A modern version of the Hippocratic Oath:

“I swear to fulfill, to the best of my ability and judgment, this covenant:

“I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

“I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism. (‘Those that hold the belief that life is meaningless, reject moral and religious values as well as political and social institutions.’)

“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

“I will not be ashamed to say ‘I know not,’ nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

“I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially I must tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

“I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

“I will prevent disease whenever I can, for prevention is preferable to cure.

“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

“If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”

Living up to the oath

I started writing my column in January 2018 with the primary intent to educate all dental patient populations in terms of their rights regarding their treatment. I have stressed that each patient has not only a right but a responsibility to themselves to take an active part in decisions made by their doctors both medical and dental that ultimately involve their physical and emotional health. I have stressed in so many of my answers that the “Doctor is NOT always right.”

Through my three years of writing answers, an overriding theme of patients has been to ask questions regarding treatment proposed or already provided for them, be it either surgical or preventive in nature and more importantly, do these types of treatment seem appropriate? It pleases me that there is a very healthy sense of skepticism in our population when it comes to the health professions in general and Dentistry in particular. I believe it to be justified. In general terms, I believe most in our profession still do or attempt to ascribe to the Hippocratic Principles but it is those who have wavered that have brought up the need for a column such as mine.

I personally believe that in certain instances our health professionals have lost their way and do not value some of the oaths they have taken when entering our profession in addition to losing sight of the ethical principles that we all have sworn to uphold. One of those is “To Do No Harm.” Others we will talk about next week.

I am in sincere hope that all of my efforts over the last three years and going forward will have the effect of raising the practice standards of dentistry and have dentists and patients alike look more closely at what they say and as a result do the same for treatment planned and delivered.

Next week, I will return to my normal format by answering the continued questions I get about the use of silver amalgam as a restorative material in dentistry. Yes, my colleagues, I will not stop supporting the use of this most exceptional restorative material.

Dr. Richard Greenberg of Ipswich practiced dentistry for 45 years after having attended dental school at Columbia University, where he was later an associate clinical professor of restorative dentistry and facilitator of the course of ethics. Do you have a dental question or comment about the column? Email him at dr.richard@nothingbutthetooth.org.