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An Oath Betrayed?

Chapter 8 in Paul Farmer’s Book Pathologies of Power examines the role that medical ethics plays in the global health care situation as well as the responsibilities that the medical community has to provide the basic human right of health care amidst the fundamental challenges of inequity. Farmer poses what are, in his opinion, the most important questions for the future of medical ethics in global health care. One of these questions includes the role and responsibility of physicians in living up to and fulfilling “the sacred contract between physician and patient”. He presents the disturbing concept of physician facilitation of harmful practices in the name of research or the betterment of society. One of these examples is the “participation of U.S. physicians in state-sponsored executions” despite the contradictory nature of being actively involved in ending someone’s life and the moral code and ethical model inherent in being a doctor.

The death penalty example brings to mind the participation of medical professionals in torture. This article from The New England Journal of Medicine offers a disturbing look at abuse and torture in a military context in Iraq, Afghanistan, and Guantanamo Bay. It brings up an interesting point about the “potential moral conflict between between commitment to the healing of individual people, on the one hand, and responsibility to the military hierarchy and the command structure, on the other”. I think this seemingly incompatible relationship between medical ethics and the military connects to this chapter from Farmer’s book. He points out the opposition of motives, goals, and intentions of the medical community when it comes to prevention, treatment, and access to health care around the globe. Medical ethics is a multifaceted and complicated issue that seems to pose a lot of problems when it comes to the state of health care today. However, as Farmer alludes to, there is hope in the application of ethical principles in order to confront the important issues we face today.

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If you click on the picture above, it will take you to an article that describes how doctors hid evidence of torture at Guantanamo Bay.

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