Monday, July 2, 2012

Mental Illness and the Hippocratic Oath

Words are as deeds, worthy of respect or of great shame. I read a blog just recently on the medical professions judgment on transplants and then change of mind dealing with a heart transplant for a schizophrenic African-American here in North America. The beginning of the story was not very promising for the man, as he was turned down because he is schizophrenic, yet also because he was not a stable individual; his mental illness would create problems with him communicating and he would not be able to comply with instructions, albeit because of his frame of mind he was turned down from a transplant.
• “Without a new heart, this poor man only had a few months left to live so plans were made to keep him as comfortable as possible while awaiting death. The hospital ethics committee reviewed the decision to not give him a transplant and decided that the only reasons to deny him a heart were that:
• the transplant would not significantly improve his quality of life and
• he could not comply with the complex treatment regimen required after the surgery
This turned out to be not the case at all and eventually in this man’s case, and with 80-100 people standing beside him as well as family members and psychiatric support teams he was able to get the transplant and survive.
Hippocratic Oath - Wikipedia, the free encyclopedia
“...I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I 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 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....”
My question is, what is the reasoning behind the Hippocratic Oath if the Mentally Ill are turned away. Is this because they are not stable or because they may not be a value to society any further? Is this a statement of prejudice on the part of doctors whom have taken oath to heal within their means those of sound body and mind as well as those of whom are ill? In Japan a 35 year old man was denied a lung transplant simply on the grounds stated above not being of sound body, nor of mind nor of a value to society, even though he remains stable on medication for his mental illness he too is a sufferer, because of what profit will remain after he may be saved from a transplant not being of “sound mind or body”? Is this the future of Psychiatry as well to be imagined?
Written by Donald S.

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