My question ... IS that, in fact, what the Hippocratic Oath is? An Oath to do NO harm, period? Or just an Oath to do no harm as a healer? i.e. to always try to help the sick and wounded, and never do anything that could harm a patient.
Its generally expected that the oath pertains to the patient under the physician's hands at the moment. Because the patient is completely vulnerable, there has to be some basic trust that the Physician won't kill when given the chance.
Remember the beginning of the movie, when the Klingon Chancellor is dying and Bones asks to be allowed to help. In that instance he wasn't a Starfleet officer trying to kill the enemy, he was a Medical Doctor trying to save his patient.
McCOY: Aren't you carrying a surgeon?
CHANG: We were until this disgrace.
McCOY: Then for God's sake, man, let me help. ...
I've got a pulse. We can move him. ...
I'm gonna need some light. Can we get him on the table? ...
Hold him! Hold him, while I stabilize him. ...
I said hold him! ...
Sweet Jesus!
KIRK: Can you?...
McCOY: Jim, I don't even know his anatomy. ...His wounds are not closing.
KERLA: He's killing him!
McCOY: He's gone into some kind of damned arrest. ...
Come on, dammit! Come on. ...
He's not responding.
GORKON: Don't let it end this way, Captain.
Getting back to
"The Oath".
There are many Oaths, rewritten over the years to try and meet the moralities of the day. The precept to avoid "abortion" is removed from many modern versions.
They are also rewritten when medical science advances occur. For instance, Doctors no longer fear "cutting for stone" because with current techniques its no longer the death sentence it was back in
Xena Warrior Princess days.
Finally, "The Oath" simply means different things to different people.
It's not a hard and fast rule like the 3 laws of Assimovian Robotics, nor a binding agreement with a deity since the vast majority of Doctors do not follow
Apollo the Physician and
Asclepius and
Hygieia and
Panaceia.
The Oath is rather an acknowledgment that between the Doctor and the patient there
is something more sacred than between a Starbucks barrista and her caffienated customer.
Bones was a physician, but he was also a Starfleet officer. By helping Spock he was protecting his ship, his Starfleet Command, and getting a little payback on the guy who sent him to his "death" on the Klingon prison world.
I personally have no problem with that action.
I have more problem with a Doctor using his/her relationship to kill a patient. As demonstrated in
I Borg: (Yes, I love Beverly!)
LAFORGE: If this works the way I think it will, once the invasive program starts spreading, it'll only be a matter of months before the Borg suffer total systems failure.
PICARD: Comments.
CRUSHER: A question. What exactly is total systems failure?
DATA: The Borg are extremely computer dependent. A systems failure will destroy them.
CRUSHER: I just think we should be plain about that. We're talking about annihilating an entire race.
PICARD: Which under most circumstances would be unconscionable. But as I see it, the Borg leave us with little choice.
RIKER: I agree. We're at war.
CRUSHER: There's been no formal declaration of war.
TROI: Not from us, but certainly from them. They've attacked us in every encounter.
PICARD: They've declared war on our way of life. We are to be assimilated.
CRUSHER: But even in war there are rules. You don't kill civilians indiscriminately.
RIKER: There are no civilians among the Borg.
PICARD: Think of them as a single, collective being. There's no one Borg who is more an individual than your arm or your leg.
CRUSHER: How convenient.
PICARD: Your point, Doctor?
CRUSHER: When I look at my patient, I don't see a collective consciousness. I don't see a hive. I see a living, breathing boy who's been hurt and who needs our help. And we're talking about sending him back to his people as an instrument of destruction.
PICARD: It comes down to this. We're faced with an enemy who are determined to destroy us, and we have no hope of negotiating a peace. Unless that changes, we are justified in doing anything we can to survive.
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about.
If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honoured with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
The precepts of this oath are still seen in modern medical practice. The right of privacy, not to have your ailments be the fodder for the masses on "Entertainment Tonight". Not to become sexually involved with your patients (Sorry EMH) is actually a State license requirement in the US.
The corollary,
"First, do no harm" means don't just DO something to do it. Sit back and watch the patient to see IF something needs to be done. As Hippocrates taught 2500 years ago, left alone the patient often can heal himself... IF the Physician doesn't get in the way.
