Primum non nocere
The Hippocratic Oath is by no means the only one that has been taken by medical students and graduates the world over, today and through the many centuries of recorded history. The Oath of Asaph in ancient Hebrew, Vaidya’s Oath in Vedic India, the Sun Simiao of Sui-dynasty China, the teachings of Nagarjuna in the Mahayana Buddhist tradition, fragmentary hints in ancient Mesopotamian and Egyptian records — are among the many known parallels from antiquity, crossing all cultural lines. They provide startling evidence of the universality of the moral principles recognized in the school of Hippocrates: the Greek physician who flourished more than four centuries before the birth of Christ. There are, too, innumerable mediaeval and modern parallels, and testimonies to an identical reasoning. Books can be filled with this.
Readers of C.S. Lewis’s best book — The Abolition of Man — will be aware of such phenomena. He provided as an appendix many pages of parallel passages illustrating what he called, for popularity, “The Tao,” but showed to be the same as what we have called “Natural Law” in our Western tradition.
As a child, still in grade school, a book fell into my hands entitled The Portable World Bible (edited Ballou, 1944), with excerpts from scriptural works of all the major religions. Long before I became a Christian I was aware from this, and then many other sources, that there are universal truths: the philosophia perennis. And perhaps also, globalizing lies, being all attempts to deny or ignore them. “Multiculturalism” is an expression of the Great Lie today: the idea that each culture has only arbitrary beliefs, that one is as good as another, and that the only way to resolve the contradictions between them is through the moral and intellectual idiocy of a statist atheism, pretending to be neutral.
I used that word “idiocy” in a strict sense, ultimately derived from the Greek idios, suggesting not merely ignorance and mental deficiency, but more fundamentally: disconnexion, separation, isolation, alienation, atomization, aloneness. Atheism is an inevitable expression of this condition, but the “statist” adjective may have to be explained. Here I refer to what, for want of a better term, I call the essential autism of the modern state, which declares itself to be detached from any private interest. “Equality” is the modern, democratic ideal, reducing citizens to interchangeable cyphers, whose defining characteristics may then be overlooked. It is through this visor, this statistical abstraction, that the moral and intellectual idiot (or, “policy wonk”) views all matters that impinge on human life. We have reached an extreme where so fundamental a distinction between persons as that between a man and a woman can be shrugged off, dismissed, denied — with a glibness, a blankness of face and hollowness of soul, that should chill every heart.
After the last World War, the World Medical Association sponsored a revival of oath-taking by doctors in reaction to the suppression of the Hippocratic Oath in Nazi Germany. Gentle reader may perhaps guess why it would have been suppressed there. So long as the memory of Auschwitz is alive — and it is already fading from the popular consciousness — the lessons learnt may be vaguely recollected. But generations pass, and it is the fate of men to relearn truths by repeating catastrophes. How many of us, living and adult, can even remember what we learnt on the morning of 11th September, 2001?
The last time I mentioned the Hippocratic Oath in this space, a fortnight ago, I received a glib email from a correspondent who has been heckling me at intervals for at least twenty years. (His “avatar” is now a picture of George Orwell.) This clever fellow pointed out that “first do no harm” (a phrase I hadn’t used) is not in the text of the original oath. I daresay he found this “fun fact” in Wikipedia; primum non nocere was a brilliantly succinct nineteenth-century paraphrase of what that Oath articulates. He went on to tell me that I’m out of date, that the Oath is no longer mandated in white-coat ceremonies, that it never had any legal force, and that even where it is still recited the text has been revised and modernized to take account of “medical advances.”
Smug, as well as glib, the idiot didn’t remember that I had more than once previously shown myself perfectly aware of each of his points. And, before I gave up replying to him, I had also noted that his last point was a flat lie. There has been no technological advance that could possibly obviate the Hippocratic Oath, whose meaning has been intelligible to every generation, and retains its crystal clarity today. Instead it is altered to accommodate abortion and euthanasia — both of which were specifically and unambiguously condemned in the original. What this shows is not medical progress over the last two thousand four hundred years, but moral disintegration through the last fifty.
There is no more point in arguing with such a man, than with an audio loop, or an “ISIS” decapitator. Nor should we doubt he speaks for the majority, today — for what I call the “idiotized” masses; for the politicians they put into power; and for the judges and bureaucrats the politicians set in place. (Take this in: our Canadian Supreme Court voted for “physician-assisted dying,” nine-zero.) We are defenceless against people who do not value their own lives, let alone ours. But though in the end they may kill themselves and us, they cannot kill God.
It is true that the Hippocratic Oath is not legally enforceable, today. It may not even have been enforceable at the time it was written; though it is more likely the concept of honour was understood then. For it is an extremely solemn oath, and carries the sting in its last sentence. He who pledges it hopes to be ruined, should he ever betray it.
Primum non nocere, “first do no harm.” Our task is to keep this alive in our hearts: not only Christians, but every man and woman capable of decency. Every doctor and nurse and medical assistant who is not a murderer must keep it alive — pay any price rather than become complicit in a heinous evil. It is a phrase that resonates with a truth that is immortal, and will stand even as our world passes away.