Stamp of Approval — or Not

April 30, 2014 • Posted in Blog

Transkei stamp honoring Hippocrates

D. Joy Riley, M.D., M.A.

Hippocrates, the “father of medicine,” was honored by this commemorative stamp issued by Transkei in 1982. The Rod of Asclepius — the rod entwined by a serpent — as the symbol of medicine is included on the stamp as well.

Image: Hippocratic Medicine stamp from Australia, recognizing the General Assembly of World Medical Associations (~1968).

Asclepius, the Greek god associated with healing, is one of the gods referred to in the Hippocratic Oath. The Hippocratic Oath (probably not written by Hippocrates, by the way) in its ancient form included swearing to a number of gods and goddesses; forbade the practitioner from performing abortions or euthanasia; and held the physician to high standards of confidentiality as well as care for his patients.

Although the number of medical schools administering the oath has increased in the last century, the oaths used are less and less like the original.

The Australian stamp below was issued in celebration of the General Assembly of World Medical Associations almost 50 years ago. At that time, the hypodermic syringe was a symbol of cure. Now, the picture of gloved hands administering an injection can represent something much more menacing.

Australian Stamp recognizing General Assembly of World Medical Associations (~1968)

Consider the position of the Belgian Society of Intensive Care Medicine, published in February in the Journal of Critical Care (Vol. 29(1): 174-5). They advocate:

  1. “administration of sedative agents with the direct intention of shortening the process of terminal palliative care in patients with no prospect of a meaningful recovery.”
  2. all team members should be included in the decisions made, but the responsibility for the decision belongs to the ICU physician; once the decision is made, “all members of the team must apply the plan that has been decided on.”
  3. “Shortening the dying process with use of medication, such as analgesics/sedatives, may sometimes be appropriate, even in the absence of discomfort . . .”
  4. “Through the entire process, the intention must not be interpreted as killing but as a humane act to accompany the patient at the end of his/her life.”
  5. “The present document applies to children as well as to adults.”

Shorten the dying process but don’t call it killing? Instead, call it humane? Apply this procedure to not only adults, but children also? This is not medicine, but madness.

Perhaps a stamp should be designed for the Belgian Society of Intensive Care Medicine. It could have a pair of hands with a hypodermic syringe like the stamp pictured, but without Hippocrates. Euthanasia is not consistent with Hippocratic medicine. But more changes would be needed. The society should also change its name: medicine denotes a remedy or healing. Getting rid of the patient is not the same as eradicating the disease. Further, care intends concern or regard for, or even, “to protect”; care has never before been synonymous with killing. The word “dispatchers” comes to mind. Aside from the name change, I do have a proposal for the visual on the stamp. Perhaps this would be fitting:

Drawing of a stethoscope turned into a serpent

This stethoscope-turned-serpent incorporates two important symbols of medicine, and in doing so, reveals the truth about the “treatment” proposed.