What Is the End of Medicine? One-Pager

Undergraduate Curriculum

The Question

Medicine’s proper end is health: restoring or improving health, and caring for people when cure is not possible.
Health concerns the functioning of the whole person and contributes to flourishing. The outline distinguishes it from pleasure, the absence of suffering, and indefinite prolongation of life.

Significance

Patients are vulnerable and must be able to trust that physicians act for their good. A shared commitment to health supports that trust.
Medical skill can be used toward competing aims. Technical ability alone does not establish that an intervention belongs within good medical practice.

Implications

Ask what good an intervention serves, whether it promotes health, and what limits follow from medicine’s purpose.
Develop both clinical competence and moral judgment. The Oath places duties to patients alongside duties to teachers, students, and the medical community.

Reading Excerpt

The Hippocratic Oath

I swear by Apollo Physician, by Asclepius, by Health, by Panacea and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician's oath, but to nobody else. I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly, I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein. Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets. Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I transgress it and forswear myself, may the opposite befall me.

Discussion Questions

Does the Oath assume that medicine has its own moral limits? If so, where do those limits come from?
Why is the promise “never with a view to injury and wrong-doing” central to the physician’s identity?
The Oath says, “I will keep pure and holy both my life and my art.” Why might the physician’s personal character matter for the practice of medicine?

Sources: LearnWorlds outline; reading and selected discussion questions.