D. Joy Riley, M.D., M.A.
Executive Director
Recently, I had the opportunity to hear Dr. John Patrick speak. It was a fairly wide-ranging lecture, but the mention of the Registry of Hippocratic Physicians caught my ear. So I contacted him to ask about that, and he agreed to a telephone interview. That follows below . . .
D. Joy Riley (DJR): How shall I introduce you to our readers? You are a British physician, with extensive experience feeding malnourished children in the Caribbean and Africa. You now call Ottawa, Canada, your home. What else do they need to know about you?
Dr. John Patrick (JP): I am a repentant physician who came out of the woodwork. I had been teaching many years when my university sent around a message stating that teaching should be from a morally neutral position. I responded by writing a paper on “The Myth of Moral Neutrality.” It changed my life.
Somehow the paper was circulated about, and speaking opportunities arose. At one point, I was giving 400 lectures a year. You could say I am a “compulsive teacher.”
DJR: Tell me about the Registry of Hippocratic Physicians. How did that happen?
JP: 15-20 years ago, I tried to persuade physicians of four key ideas in “What Hippocrates Knew and We Have Forgotten”:
- What is the role of transcendence in medicine?
- What is the real nature of medicine?
- What is the practical test of a physician’s commitment to the view?
- What requirements does he need to receive from society for that to continue?
DJR: Perhaps you should explain those questions.
JP: Certainly.
- If your doctor does not fear consequences after death, then you need to fear your doctor. The Dutch data show 500-1,000 people are killed every year without evidence of consent. They even kill babies, especially those with spina bifida.
- Because we believe patients are free agents, no patient coming to see us must take our advice. What we do is help them decide what they ought to do. This is a fact-value distinction. Imagine you have cancer; I, the doctor, have invented the cure. Ought I to give it to you? It depends. If I believe that I should do good, then the answer is yes. If, however, I am a Darwinian, I will have my best interests in mind. The answer might be no, especially if I am to inherit your worldly goods.
- The key test of whether we understand this is the recognition that trust is at the heart of medicine.
- Rights of conscience: we have a moral activity in a society that does not have a moral consensus. How does a moral activity function in that society? It doesn’t. We are a group of people that live together primarily for economic reasons.
DJR: Tell me about the Hippocratic Registry of Physicians.
JP: We began it 10 years ago. It is an international registry. Our symbol, made into lapel pins, is the correct caduceus: the rod of Asclepius (pictured right). The winged one is not correct for physicians: that is the symbol of Mercury, the god of businessmen and thieves.
DJR: Well, that sounds like a conversation piece.
JP: Perhaps more than you know. The first time I wore the lapel pin, I had to stop by my bank to conduct some business. I have known the tellers there for years. That day, the teller noted my pin, and asked me, “What is that badge you are wearing today? What does it mean?”
I responded with, “It means I won’t kill you,” and my compulsive teacher self continued the lesson.
DJR: Please share some of your thoughts about right of conscience, which has lately been in the news in Canada.
JP: Obviously, moral neutrality is a myth in this regard. In the modern medical system, when trainees are asked to do procedures to which they object, they should ask their mentors if they can ask two questions of them:
- Do you wish you and your family to be cared for by a doctor with or without moral integrity?
- I see that the issue of (abortion, euthanasia, for example) is not a moral issue for you. But it is for me. If you insist that I do this, you will diminish my moral integrity now and for the rest of my life. Is that what you wish to do?
DJR: Very insightful questions, Dr. Patrick. You have provided much food for thought. Finally, if our readers would like to contact you, how would they do that?
JP: Visit our website to learn more. If they wish to contact us or register as Hippocratic physicians, they can do so at this page.
DJR: Thank you for your time.
Further Reading:
The Physician’s Oath and Prayer of Maimonides
See also: Orr, Robert D.; Pang, Norman; Pellegrino, Edmund D.; Siegler, Mark, “Use of the Hippocratic Oath: a Review of Twentieth Century Practice and a Content Analysis of Oaths Administered in Medical Schools in the U.S. and Canada in 1993,” Journal of Clinical Ethics 1997 Winter; 8(4): 377-388.
While the practice of oath-taking by North American physicians in the last century increased, the content of the oaths changed significantly over that time. They concluded: “When compared to the contents of the classical Hippocratic Oath, currently used oaths are less likely to agree to be accountable, invoke a deity, or forswear euthanasia, abortion, or sexual contact with patients.”